Your browser doesn't support javascript.
loading
Trends in management and outcomes of pulmonary embolism with a multidisciplinary response team.
Chopard, Romain; Campia, Umberto; Morin, Lucas; Jering, Karola S; Almarzooq, Zaid I; Snyder, Julia Elizabeth; Rizzo, Samantha; Waxman, Aaron B; Goldhaber, Samuel Z; Piazza, Gregory.
Afiliación
  • Chopard R; Department of Cardiology, University Hospital Jean Minjoz, Besançon, France.
  • Campia U; EA3920, University of Burgundy Franche-Comté, Besançon, France.
  • Morin L; F-CRIN, INNOVTE Network, Saint-Etienne, France.
  • Jering KS; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA.
  • Almarzooq ZI; Inserm CIC 1431, Clinical Investigation Unit, University Hospital Jean Minjoz, Besançon, France.
  • Snyder JE; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA.
  • Rizzo S; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA.
  • Waxman AB; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA.
  • Goldhaber SZ; Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA.
  • Piazza G; Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Thromb Thrombolysis ; 54(3): 449-460, 2022 Oct.
Article en En | MEDLINE | ID: mdl-36057054
Multidisciplinary pulmonary embolism (PE) response teams have garnered widespread adoption given the complexities of managing acute PE and provide a platform for assessment of trends in therapy and outcomes. We describe temporal trends in PE management and outcomes following the deployment of such a team. All consecutive patients managed by our multidisciplinary PE response team activated by the Emergency Department were included over a 5-year calendar period. We examined temporal trends in management and rates of a composite primary endpoint (all-cause-death, major bleeding, recurrent venous thromboembolism, and readmission) at 30 days and 6 months. We assessed 425 patients between 2015 and 2019. We observed an increase in PE acuity and use of systemic thrombolysis. The primary endpoint at 30 days decreased from 16.3% in 2015 to 7.1% in 2019 (adjusted rate ratio per period, 0.63; 95%CI, 0.47-0.84), driven by a decrease in the adjusted rate of major bleeding. Among 406 patients with complete follow-up, the adjusted rate ratio per year for the primary outcome at 6 months was 0.37 (95%CI, 0.19-0.71), driven by a decrease in all-cause mortality. We observed evidence of temporal changes in clinical presentation, therapeutic strategies, and outcomes for acute PE, in parallel to, but not necessarily because of, the implementation of a multidisciplinary response team. Over time, major bleeding, mortality and readmission rates decreased, despite an increase in PE risk category.
Asunto(s)
Palabras clave

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Embolia Pulmonar / Tromboembolia Venosa Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Año: 2022 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Embolia Pulmonar / Tromboembolia Venosa Tipo de estudio: Diagnostic_studies Límite: Humans Idioma: En Año: 2022 Tipo del documento: Article