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多学科肺栓塞应对团队诊治患者的特征与结局:5年经验

Characteristics and Outcomes of Patients Consulted by a Multidisciplinary Pulmonary Embolism Response Team: 5-Year Experience.

作者信息

Pietrasik Arkadiusz, Gąsecka Aleksandra, Kurzyna Paweł, Wrona Katarzyna, Darocha Szymon, Banaszkiewicz Marta, Zieliński Dariusz, Zajkowska Dominika, Smyk Julia Maria, Rymaszewska Dominika, Jasińska Karolina, Wasilewski Marcin, Wolański Rafał, Procyk Grzegorz, Szwed Piotr, Florczyk Michał, Wróbel Krzysztof, Grabowski Marcin, Torbicki Adam, Kurzyna Marcin

机构信息

1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland.

Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre Otwock, 05-400 Otwock, Poland.

出版信息

J Clin Med. 2022 Jun 30;11(13):3812. doi: 10.3390/jcm11133812.

Abstract

(1) Background: Pulmonary embolism (PE) is the third most frequent acute cardiovascular condition worldwide. PE response teams (PERTs) have been created to facilitate treatment implementation in PE patients. Here, we report on the 5-year experience of PERT operating in Warsaw, Poland, with regard to the characteristics and outcomes of the consulted patients. (2) Methods: Patients diagnosed with PE between September 2017 and December 2021 were included in the study. Clinical and treatment data were obtained from medical records. Patient outcomes were assessed in-hospital, at a 1- and 12-month follow-up. (3) Results: There were 235 PERT activations. The risk of early mortality was low in 51 patients (21.8%), intermediate-low in 83 (35.3%), intermediate-high in 80 (34.0%) and high in 21 (8.9%) patients. Anticoagulation alone was the most frequently administered treatment in all patient subgroups (altogether 84.7%). Systemic thrombolysis (47.6%) and interventional therapy (52%) were the prevailing treatment options in high-risk patients. The in-hospital mortality was 6.4%. The adverse events during 1-year follow-up included five deaths, two recurrent VTE and two minor bleeding events. (4) Conclusions: Our initial 5-year experience showed that the activity of the local PERT facilitated patient-tailored decision making and the access to advanced therapies, with subsequent low overall mortality and treatment complication rates, confirming the benefits of PERT implementation.

摘要

(1) 背景:肺栓塞(PE)是全球第三常见的急性心血管疾病。已设立肺栓塞应对小组(PERTs)以促进对PE患者的治疗实施。在此,我们报告波兰华沙PERTs运作5年的经验,涉及咨询患者的特征和结局。(2) 方法:纳入2017年9月至2021年12月期间诊断为PE的患者。从病历中获取临床和治疗数据。在住院时、1个月和12个月随访时评估患者结局。(3) 结果:共激活PERTs 235次。51例患者(21.8%)早期死亡风险低,83例(35.3%)中低,80例(34.0%)中高,21例(8.9%)高。在所有患者亚组中,单独抗凝是最常用的治疗方法(共84.7%)。全身溶栓(47.6%)和介入治疗(52%)是高危患者的主要治疗选择。住院死亡率为6.4%。1年随访期间的不良事件包括5例死亡、2例复发性VTE和2例轻微出血事件。(4) 结论:我们最初5年的经验表明,当地PERTs的活动促进了针对患者的决策制定和获得先进治疗,随后总体死亡率和治疗并发症率较低,证实了实施PERTs的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56bb/9267516/b51583fac6ae/jcm-11-03812-g001.jpg

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