Pulmonary embolism response team consulting practices and in-hospital outcomes in intermediate-high and high-risk pulmonary embolism.

The goal of this analysis is to evaluate factors associated with PERT consultation and to determine if PERT consultation was associated with differences in outcomes for patients with intermediate-high and high-risk PE. All intermediate-high or high-risk PE cases at a single institution from 2016 to 2019 were reviewed. Outcomes were in-hospital mortality, length of stay (LOS), and moderate/severe bleeding. Clinical characteristics, imaging findings, and outcomes were compared between cases with and without PERT consultation. 335 cases were included, with PERT consulted in 52%. PERT was consulted more in cases with increased right ventricle (RV) size and depressed RV function (both p < 0.0001). PERT was consulted more for saddle (85.5%, p < 0.0001) and less for segmental (39.0%, p < 0.0001) PE. Use of catheter-based therapies, such as catheter-directed thrombolysis (23.0% vs. 1.9%, p < 0.001), was higher within the PERT group. Cases with PERT involvement had a shorter mean LOS (13 vs. 24 days), lower in-hospital mortality (8.1% vs. 21.0%), and less bleeding (9.8% vs. 21%) (all p < 0.004); there was no difference in PE-related mortality (p = 0.51). In multivariate analyses, PERT consultation was a predictor of lower in-hospital mortality (OR 0.30, CI 0.15-0.64, p = 0.002), bleeding (OR 0.43, CI 0.22-0.85, p = 0.01), and LOS (OR 0.38, CI 0.22-0.67, p = 0.0007). PERT was consulted more in cases of central PE and cases with greater signs of RV strain. PERT was associated with increased use of catheter-based therapies, lower in-hospital mortality and bleeding, and a shorter LOS.