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Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis
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 Scie...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724819/ https://www.ncbi.nlm.nih.gov/pubmed/35831010 http://dx.doi.org/10.1183/16000617.0023-2022 |
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author | Fleitas Sosa, Derlis Lehr, Andrew L. Zhao, Huaqing Roth, Stephanie Lakhther, Vlad Bashir, Riyaz Cohen, Gary Panaro, Joseph Maldonado, Thomas S. Horowitz, James Amoroso, Nancy E. Criner, Gerard J. Brosnahan, Shari B. Rali, Parth |
author_facet | Fleitas Sosa, Derlis Lehr, Andrew L. Zhao, Huaqing Roth, Stephanie Lakhther, Vlad Bashir, Riyaz Cohen, Gary Panaro, Joseph Maldonado, Thomas S. Horowitz, James Amoroso, Nancy E. Criner, Gerard J. Brosnahan, Shari B. Rali, Parth |
author_sort | Fleitas Sosa, Derlis |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9724819 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-97248192022-12-08 Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis Fleitas Sosa, Derlis Lehr, Andrew L. Zhao, Huaqing Roth, Stephanie Lakhther, Vlad Bashir, Riyaz Cohen, Gary Panaro, Joseph Maldonado, Thomas S. Horowitz, James Amoroso, Nancy E. Criner, Gerard J. Brosnahan, Shari B. Rali, Parth Eur Respir Rev Reviews 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. European Respiratory Society 2022-07-13 /pmc/articles/PMC9724819/ /pubmed/35831010 http://dx.doi.org/10.1183/16000617.0023-2022 Text en Copyright ©The authors 2022 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Reviews Fleitas Sosa, Derlis Lehr, Andrew L. Zhao, Huaqing Roth, Stephanie Lakhther, Vlad Bashir, Riyaz Cohen, Gary Panaro, Joseph Maldonado, Thomas S. Horowitz, James Amoroso, Nancy E. Criner, Gerard J. Brosnahan, Shari B. Rali, Parth Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis |
title | Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis |
title_full | Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis |
title_fullStr | Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis |
title_full_unstemmed | Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis |
title_short | Impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis |
title_sort | impact of pulmonary embolism response teams on acute pulmonary embolism: a systematic review and meta-analysis |
topic | Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724819/ https://www.ncbi.nlm.nih.gov/pubmed/35831010 http://dx.doi.org/10.1183/16000617.0023-2022 |
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