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1.
J Thromb Thrombolysis ; 47(1): 41, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30506351

RESUMO

The original version of the article unfortunately contained an error in conflict of interest. This erratum is published with the correct conflict of interest.

2.
J Thromb Thrombolysis ; 47(1): 31-40, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30242551

RESUMO

Multidisciplinary pulmonary embolism response teams (PERTs) are being implemented to improve care of patients with life-threatening PE. We sought to determine how the creation of PERT affects treatment and outcomes of patients with serious PE. A pre- and post-intervention study was performed using an interrupted time series design, to compare patients with PE before (2006-2012) and after (2012-2016) implementation of PERT at a university hospital. T-tests, Chi square tests and logistic regression were used to compare outcomes, and multivariable regression were used to adjust for differences in PE severity. Two-sided p-value < 0.05 was considered significant. For the interrupted time-series analysis, data was divided into mutually exclusive 6-month time periods (11 pre- and 7 post-PERT). To examine changes in treatment and outcomes associated with PERT, slopes and change points were compared pre- and post-PERT. Two-hundred and twelve pre-PERT and 228 post-PERT patients were analyzed. Patient demographics were generally similar, though pre-PERT, PE were more likely to be low-risk (37% vs. 19%) while post-PERT, PE were more likely to be submassive (32% vs. 49%). More patients underwent catheter directed therapy (1% vs. 14%, p = < 0.0001) or any advanced therapy (19 [9%] vs. 44 [19%], p = 0.002) post PERT. Interrupted time series analysis demonstrated that this increase was sudden and coincident with implementation of PERT, and most noticeable among patients with submassive PE. There were no differences in major bleeding or mortality pre- and post-PERT. While the use of advanced therapies, particularly catheter-directed therapies, increased after creation of PERT, especially among patients with submassive PE, there was no apparent increase in bleeding.


Assuntos
Atenção à Saúde/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Embolia Pulmonar/terapia , Atenção à Saúde/tendências , Medicina de Emergência/tendências , Feminino , Hospitais Universitários , Humanos , Estudos Longitudinais , Masculino , Equipe de Assistência ao Paciente/tendências , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento
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