Pulmonary Embolism Response Team - a multidisciplinary approach to pulmonary embolism treatment. Polish PERT Initiative Report.

Background: A pulmonary embolism response team (PERT) is a multidisciplinary team established to improve clinical care for patients with pulmonary embolism (PE). However, data regarding detailed institutional experience and clinical outcomes from such teams are sparse. Aims: We aim to assess the frequency of activations, patients’ characteristics, PE severity, applied treatments, and outcomes of PE patients treated by Polish PERTs. Methods: The survey registry was conducted between June 2018 and July 2020. All consecutive PERT activations of four institutionalized PERTs in Poland were analyzed. Patients’ characteristics, therapies applied, and in-hospital outcomes were evaluated. Results: There were 680 unique PERT activations. The majority of activations originated from emergency departments (44.9%), and the remaining originated from internal medicine/cardiology units (31.1%), surgery/orthopedics (9.1 %), oncology (6.3%), intensive care units (6.0%), and others (2.5%). The origin of activation varied significantly between institutions (P <0.01). Most PERT cases were patients with intermediate-high risk PE (42.9%), whereas high-risk PE occurred in 10% of patients. Anticoagulation alone was delivered to 80.3% patients, and 23.3% patients received at least one advanced therapy: catheter directed therapies (11.3%), systemic thrombolysis (5.3%), surgical embolectomy (2.4%), vena cava filter placement (3.7%), and extracorporeal membrane oxygenation (0.6%). In-hospital mortality in the whole study group was 5.1%, with significant differences between institutions (P = 0.01). Conclusions: The frequency of PE severity, type of delivered catheter-directed treatment, and in-hospital mortality varies between institutions without significant discrepancies in PERT activations. This variation between expert centers highlights the local differences in PERTs’ organizational and operational forms.