Effect of a Multidisciplinary Pulmonary Embolism Response Team on Patient Mortality.
Effect of a Multidisciplinary Pulmonary Embolism Response Team on Patient Mortality.
复制标题
多学科肺栓塞反应团队对患者死亡率的影响。
DOI：
10.1016/j.amjcard.2021.08.066
复制
发表时间：
2021-12-15
期刊：
影响因子：
--
通讯作者：
Cameron SJ
中科院分区：
文献类型：
--
作者：
Wright C;Goldenberg I;Schleede S;McNitt S;Gosev I;Elbadawi A;Pietropaoli A;Barrus B;Chen YL;Mazzillo J;Acquisto NM;Van Galen J;Hamer A;Marinescu M;Delehanty J;Cameron SJ
多学科肺栓塞症应对小组(PERTS)可以改善高危肺栓塞(PE)患者的护理。PERT对长期死亡率的影响从未被评估过。对PERT前的137名患者(2014至2015年)和PERT实施后的231名患者(2016至2019年)进行了观察性分析，这些患者向一家学术医学中心的急诊科提交了亚大规模和大规模PE。主要结果是6个月死亡率，通过单变量和多变量分析进行评估。PERT与6个月内死亡率的持续下降有关(PERT后6个月死亡率为14%，PERT前为24%，未经调整的HR为0.57，RRR为43%，p=0.025)。实施PERT后住院时间减少(9.1d比6.5d，P=0.007)。从分诊到诊断PE的时间是死亡率的独立预测因素，每早诊断一小时，死亡风险就降低5%。总而言之，这项研究首次证明了PERT的实施与高危PE患者6个月死亡率的持续降低之间的关联。
Multidisciplinary Pulmonary Embolism Response Teams (PERTs) may improve the care of patients with high risk pulmonary embolism (PE). The impact of a PERT on long-term mortality has never been evaluated. An observational analysis was conducted of patients, 137 before PERT (between 2014 and 2015) and 231 after PERT implementation (between 2016 to 2019), presenting to the emergency department of an academic medical center with submassive and massive PE. The primary outcome was six-month mortality, evaluated by univariate and multivariate analyses. PERT was associated with a sustained reduction in mortality through six-months (six-month mortality rates of 14% post-PERT vs. 24% pre-PERT, unadjusted HR of 0.57, RRR of 43%, p=0.025). There was a reduced length of stay following PERT implemenation (9.1 vs. 6.5 days, P=0.007). Time from triage to diagnosis of PE was independently predictive of mortality, and the risk of mortality was reduced by 5% for each hour earlier that the diagnosis was made. In conclusion, this study is the first to demonstrate an association between PERT implementation and a sustained reduction in 6-month mortality for patients with high risk PE.
登录
查看更多内容
影响因子：
7.5
作者：
Grosse SD;Nelson RE;Nyarko KA;Richardson LC;Raskob GE
通讯作者：
Raskob GE
DOI：
10.1177/1358863x18767753
发表时间：
2018-08
期刊：
Vascular medicine (London, England)
影响因子：
--
作者：
Elbadawi A;Wright C;Patel D;Chen YL;Mazzillo J;Cameron P;Barnes GD;Cameron SJ
通讯作者：
Cameron SJ
影响因子：
--
作者：
Provias, Tim;Dudzinski, David M;Kabrhel, Christopher
通讯作者：
Kabrhel, Christopher
影响因子：
2.8
作者：
Chaudhury, Pulkit;Gadre, Shruti;Bartholomew, John R.
通讯作者：
Bartholomew, John R.
影响因子：
4.5
作者：
Harris PA;Taylor R;Thielke R;Payne J;Gonzalez N;Conde JG
通讯作者：
Conde JG