1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland.
1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
Kardiol Pol. 2020 Apr 24;78(4):300-310. doi: 10.33963/KP.15230. Epub 2020 Mar 12.
Pulmonary embolism (PE) is the third most common potentially life‑threatening cardiovascular disease. A new approach of pulmonary embolism response teams (PERTs) has been introduced to provide rapid multidisciplinary assessment and treatment of patients with PE. However, detailed data on institutional experience and clinical outcomes from such teams are missing.
The aim of this study was to report our experience with the management of PE guided by the PERT-POZ within the first year of operation.
We performed a prospective study of PERT-POZ activations at a university care center between October 2018 and October 2019. Patient characteristics, therapies, and clinical outcomes were evaluated.
There were 86 unique PERT-POZ activations, and PE was confirmed in 80 patients including: 9 patients (11.25%) classified as low‑risk PE, 19 (23.75%) as intermediate‑low risk, 38 (47.5%) as intermediate‑high, and 14 (17.5%) as high‑risk. Sixty patients (75%) received anticoagulation only, 28 (35%) direct oral anticoagulant, 7 (8.75%) vitamin K antagonist, 23 (28.75%) low-molecular-weight heparin, and 2 (2.50%) unfractionated heparin. Ten patients (12.5%) were treated with catheter‑directed thrombectomy, 6 (7.5%) received systemic thrombolysis, 2 (2.5%) underwent surgical embolectomy, 2 (2.5%) were on extracorporeal membrane oxygenation support, and 2 (2.5%) underwent pharmacomechanical venous thrombectomy. There were 7 (8.75%) in‑hospital deaths, and 2 (2.5%) deaths during a 3‑month follow‑up. Bleeding complications were rare: only 3 patients (3.75%) had major bleeding events, but none after administration of systemic thrombolysis.
Our study demonstrated that after the creation of PERT-POZ with a precise activation protocol, patients with intermediate and high‑risk PE received most optimal treatment strategies.
肺栓塞（PE）是第三大潜在危及生命的心血管疾病。为了对 PE 患者进行快速的多学科评估和治疗，引入了新的肺栓塞反应团队（PERT）方法。然而，关于此类团队的机构经验和临床结果的详细数据尚不清楚。
本研究旨在报告我们在第一个运营年内使用 PERT-POZ 指导 PE 管理的经验。
我们对 2018 年 10 月至 2019 年 10 月期间在一所大学医疗中心进行的 PERT-POZ 激活进行了前瞻性研究。评估了患者特征、治疗方法和临床结局。
共有 86 次独特的 PERT-POZ 激活，其中 80 例患者确诊为 PE，包括：9 例（11.25%）低危 PE，19 例（23.75%）中低危，38 例（47.5%）中高危，14 例（17.5%）高危。60 例（75%）患者仅接受抗凝治疗，28 例（35%）直接口服抗凝剂，7 例（8.75%）维生素 K 拮抗剂，23 例（28.75%）低分子肝素，2 例（2.50%）未分级肝素。10 例（12.5%）患者接受了导管直接血栓切除术治疗，6 例（7.5%）接受了全身溶栓治疗，2 例（2.5%）接受了手术取栓治疗，2 例（2.5%）接受了体外膜肺氧合支持，2 例（2.5%）接受了药物机械性静脉血栓切除术。有 7 例（8.75%）院内死亡，2 例（2.5%）在 3 个月随访期间死亡。出血并发症罕见：只有 3 例（3.75%）患者发生了大出血事件，但在全身溶栓治疗后无出血事件发生。
本研究表明，在创建具有精确激活方案的 PERT-POZ 后，中高危 PE 患者接受了最理想的治疗策略。
