Sylwia Sławek-Szmyt1, Stanisław Jankiewicz2, Anna Smukowska-Gorynia2, Magdalena Janus2, Aneta Klotzka2, Mateusz Puślecki3, Marek Jemielity4, Zbigniew Krasiński5, Bartosz Żabicki6, Waldemar Elikowski7, Marek Grygier2, Tatiana Mularek-Kubzdela2, Maciej Lesiak2, Aleksander Araszkiewicz2. 1. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland. sylwia.slawek@skpp.edu.pl 2. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland 3. Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland; Department of Medical Rescue, Poznan University of Medical Sciences, Poznań, Poland 4. Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland 5. General and Vascular Surgery Institute, Poznan University of Medical Sciences, Poznań, Poland 6. Department of Radiology, Poznan University of Medical Sciences, Poznań, Poland 7. Department of Internal Medicine, Józef Struś Hospital, Poznań, Poland
Abstract
BACKGROUND: 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. AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: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. AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Sylwia L Sławek-Szmyt; Stanisław Jankiewicz; Marek Grygier; Maciej Lesiak; Aleksander Araszkiewicz Journal: Cardiol J Date: 2022-03-04 Impact factor: 2.737
Authors: Arkadiusz Pietrasik; Aleksandra Gąsecka; Paweł Kurzyna; Katarzyna Wrona; Szymon Darocha; Marta Banaszkiewicz; Dariusz Zieliński; Dominika Zajkowska; Julia Maria Smyk; Dominika Rymaszewska; Karolina Jasińska; Marcin Wasilewski; Rafał Wolański; Grzegorz Procyk; Piotr Szwed; Michał Florczyk; Krzysztof Wróbel; Marcin Grabowski; Adam Torbicki; Marcin Kurzyna Journal: J Clin Med Date: 2022-06-30 Impact factor: 4.964