RT Journal Article
SR Electronic
T1 Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 220023
DO 10.1183/16000617.0023-2022
VO 31
IS 165
A1 Derlis Fleitas Sosa
A1 Andrew L. Lehr
A1 Huaqing Zhao
A1 Stephanie Roth
A1 Vlad Lakhther
A1 Riyaz Bashir
A1 Gary Cohen
A1 Joseph Panaro
A1 Thomas S. Maldonado
A1 James Horowitz
A1 Nancy E. Amoroso
A1 Gerard J. Criner
A1 Shari B. Brosnahan
A1 Parth Rali
YR 2022
UL http://err.ersjournals.com/content/31/165/220023.abstract
AB Background The impact of pulmonary embolism response teams (PERTs) on treatment choice and outcomes of patients with acute pulmonary embolism (PE) is still uncertain.Objective To determine the effect of PERTs in the management and outcomes of patients with PE.Methods PubMed, Embase, Web of Science, CINAHL, WorldWideScience and MedRxiv were searched for original articles reporting PERT patient outcomes from 2009. Data were analysed using a random effects model.Results 16 studies comprising 3827 PERT patients and 3967 controls met inclusion criteria. The PERT group had more patients with intermediate and high-risk PE (66.2%) compared to the control group (48.5%). Meta-analysis demonstrated an increased risk of catheter-directed interventions, systemic thrombolysis and surgical embolectomy (odds ratio (OR) 2.10, 95% confidence interval (CI) 1.74–2.53; p<0.01), similar bleeding complications (OR 1.10, 95% CI 0.88–1.37) and decreased utilisation of inferior vena cava (IVC) filters (OR 0.71, 95% CI 0.58–0.88; p<0.01) in the PERT group. Furthermore, there was a nonsignificant trend towards decreased mortality (OR 0.87, 95% CI 0.71–1.07; p=0.19) with PERTs.Conclusions The PERT group showed an increased use of advanced therapies and a decreased utilisation of IVC filters. This was not associated with increased bleeding. Despite comprising more severe PE patients, there was a trend towards lower mortality in the PERT group.Pulmonary embolism response teams increase use of advanced therapies for pulmonary embolism without increasing bleeding complications https://bit.ly/39NJZuw