We aimed to evaluate the impact of a multidisciplinary pulmonary embolism response team on the management and outcomes of patients with acute pulmonary embolism.
We retrospectively reviewed all patients presenting to our institution with a diagnosis of PE from July 2020 to April 2022. The primary outcome measures were in-hospital mortality, major bleeding events defined by the International Society on Thrombosis and Haemostasis (ISTH), and utilization of catheter-directed interventions (CDI). Secondary outcome measures included 30-day and 12-month mortality, hospital and intensive care unit (ICU) length of stay (LOS), vasopressor requirement, and cardiac arrest. Continuous variables were assessed with the Mann-Whitney U test and categorical variables were assessed with the chi-square or Fisher’s exact test when appropriate.
Two hundred and seventy-nine patients with acute PE were identified with 79 (28%), 173 (62%), and 27 (10%) stratified as low-risk, intermediate-risk, and high-risk, respectively. There were 133 (47.7%) PERT activations. Saddle and main pulmonary artery embolisms (P<0.001), RV strain (P=0.001), RV dysfunction (P<0.001), co-existing deep vein thrombosis (P<0.001), and dyspnea as a presenting symptom (P=0.008) were significantly associated with PERT activation. Patients evaluated by PERT were more likely to undergo CDI (49% vs. 27%, P<0.001) across risk stratification, and less likely to have an IVC filter placed (1% vs. 5%, P=0.04). PERT consultation had numerical but non-statistically significant trends towards reduced in-hospital (2% vs. 5%, P=0.2) and 30-day mortality (2% vs. 8%, P=0.06), but similar rates of 12-month mortality (7% vs. 8%, P=0.7). PERT activation was also associated with trends towards reduced rates of major bleeding (2% vs. 7%), cardiac arrests (2% vs. 7%), and vasopressor requirement (9% vs. 18%). PERT consultation decreased median ICU days by half; however, we did not observe any difference in total hospital LOS between groups.
At our institution, PERT was associated with significantly higher utilization of CDIs and improved clinical outcomes including reduced mortality and major bleeding events. PERT was also associated with less ICU days, suggesting a possible economic benefit of implementing PERT teams, although further research is needed to confirm that conclusion.

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