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肺栓塞反应团队启动后转诊并从当地急诊科收治的肺栓塞患者的特征与结局

Characteristics and Outcomes of Pulmonary Embolism Patients Transferred After Activation of Pulmonary Embolism Response Team and Admitted from Local Emergency Department.

作者信息

Jermakow Mateusz, Machowski Michał, Gałecka-Nowak Magdalena, Deutsch Karol, Il Adam, Imiela Anna, Karolak Bartosz, Perzanowska-Brzeszkiewicz Katarzyna, Pacho Szymon, Wójcik Agnieszka, Roik Marek, Krakowian Marcin, Łabyk Andrzej, Gołębiowski Marek, Pruszczyk Piotr

机构信息

Department of Internal Medicine & Cardiology, Medical University of Warsaw, Lindleya 4 St., 02-005 Warsaw, Poland.

Department of Clinical Radiology, Medical University of Warsaw, Chałubińskiego 5 St., 02-004 Warsaw, Poland.

出版信息

J Clin Med. 2025 Jan 22;14(3):677. doi: 10.3390/jcm14030677.

Abstract

The primary role of a pulmonary embolism response team (PERT) is to support decision-making processes regarding acute pulmonary embolism (PE) patients and provide advanced rescue therapies when needed. Despite a great need for its availability among physicians, PERT's usefulness is yet to be proven. : Our goal was to establish whether patients benefit from qualification by PERT for admission to a tertiary cardiology ward. : Data of all patients hospitalized due to PE for 12 months (July 2023-June 2024) were retrospectively analyzed. We aimed to compare patients admitted primarily via the emergency department with those consulted by PERT and eventually transferred from other hospitals. The primary outcome was the use of advanced therapies. We identified 167 patients (50.3% women) hospitalized with PE. Out of them, 102 (61.1%) came from the emergency department, while 65 (38.9%) patients were transferred after PERT consultation. The transferred patients generally had more severe conditions, as indicated by the ESC death risk group classification (intermediate-high and high risk, OR 19.2, 95% CI 8.3-44.2). They were more often qualified for at least one of the advanced therapies than the emergency department patients (OR 23.2, 95% CI 9.3-58.1). We found no significant differences in in-hospital mortality (6.9% versus 1.5%, OR 4.7, 95% CI 0.6-39.3). : Establishing PERT as a reference unit providing advanced treatment resulted in successfully delivering more complex treatment to severely ill PE patients. Despite their unfavorable basic characteristics, neither length of hospitalization nor in-hospital mortality seem to differ when compared to unselected, less compromised cases.

摘要

肺栓塞反应小组(PERT)的主要作用是支持针对急性肺栓塞(PE)患者的决策过程,并在需要时提供高级抢救治疗。尽管医生们非常需要该小组的服务,但其效用尚未得到证实。我们的目标是确定患者是否因PERT评估而受益于入住三级心脏病病房。回顾性分析了2023年7月至2024年6月因PE住院12个月的所有患者的数据。我们旨在比较主要通过急诊科入院的患者与经PERT会诊并最终从其他医院转来的患者。主要结局是高级治疗的使用情况。我们确定了167例因PE住院的患者(50.3%为女性)。其中,102例(61.1%)来自急诊科,而65例(38.9%)患者在PERT会诊后被转来。根据欧洲心脏病学会死亡风险组分类,转来的患者病情通常更严重(中高风险和高风险,比值比19.2,95%置信区间8.3 - 44.2)。与急诊科患者相比,他们更常符合至少一种高级治疗的条件(比值比23.2,95%置信区间9.3 - 58.1)。我们发现住院死亡率无显著差异(6.9%对1.5%,比值比4.7,95%置信区间0.6 - 39.3)。将PERT确立为提供高级治疗的参考单位,成功地为重症PE患者提供了更复杂的治疗。尽管他们的基础特征不佳,但与未筛选的、病情较轻的病例相比,住院时间和住院死亡率似乎并无差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bf8/11818581/a5c02fcf2769/jcm-14-00677-g001.jpg

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