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• W2895041119 abstract "SESSION TITLE: Pulmonary Vascular Disease 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: To study the difference in outcomes between patients with acute pulmonary embolism (PE) evaluated by a pulmonary embolism response team (PERT) who receive catheter directed therapy (CDT) versus systemic anti-coagulation (AC) alone. METHODS: This is a retrospective study of a consecutive cohort of patients with acute PE evaluated by the PERT taken from a prospective registry of consecutive acute PE patients at an urban teaching hospital from 2/2015 to 1/2018. Using a tiered approach, 350 patients with acute PE were evaluated and 52 patients were identified as warranting a PERT activation. We compared patients treated with CDT (all received AC) versus systemic AC alone. We excluded patients who received systemic thrombolysis or open embolectomy. Primary outcomes were length of stay (LOS) and 30-day survival. Secondary outcomes included major bleeding complications, readmission rate and recurrent PE. Fisher’s exact, chi-squared tests, independent t-test, logistic regression and ANOVA were used for analysis. RESULTS: Of 52 PERT patients, 12 received CDT while 31 received systemic AC alone. Patients who received CDT were younger (mean 51.8 ± 5.2 years) compared to AC alone (mean 61 ± 3.5 years). There were no differences in gender, BMI and race. Patients who received CDT were classified by ESC as low (1, 8.3%), intermediate-low (6, 50%), intermediate-high (4, 33.3%) and high (0, 0%) risk. Patients who received only systemic AC were classified by ESC as low, (10, 67.7%), intermediate-low (18, 58.1%), intermediate-high (1, 3.2%), and high risk (1, 3.2%). Patients who received CDT had a significantly shorter LOS than those on AC alone (4.98 ± 0.98 days versus 10.6 ± 1.40 days, p = 0.0018). The mortality rate for CDT and systemic AC was 0 (0%) and 6 (19.3%), respectively. Major bleeding occurred in 0 (0%) in the CDT and 1(3.2%) in the systemic AC groups. Readmission rate was 16.67% in the CDT group and 6.45% in the systemic AC group. CONCLUSIONS: PERT patients who underwent CDT had a significantly shorter LOS than those who received systemic AC alone. Given the small number of patients in this study, conclusions regarding outcomes aside from LOS were difficult to make. CLINICAL IMPLICATIONS: Further studies are needed to see how decisions are made regarding CDT versus systemic AC alone, and to evaluate the difference in outcomes and complications associated with each therapy. This will help guide the PERT in making future decisions to ensure improved patient outcomes. DISCLOSURES: No relevant relationships by Eric Bondarsky, source=Web Response No relevant relationships by Madeline Ehrlich, source=Web Response No relevant relationships by Jason Filopei, source=Web Response No relevant relationships by Boram Kim, source=Web Response No relevant relationships by Di Pan, source=Web Response No relevant relationships by Valeria Santibanez, source=Web Response No relevant relationships by Adil Shujaat, source=Web Response No relevant relationships by David Steiger, source=Web Response" @default.
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• W2895041119 date "2018-10-01" @default.
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• W2895041119 title "CLINICAL CHARACTERISTICS AND OUTCOMES OF PULMONARY EMBOLISM RESPONSE TEAM (PERT) PATIENTS RECEIVING CATHETER DIRECTED THERAPY (CDT) VERSUS SYSTEMIC ANTICOAGULATION (AC)" @default.
• W2895041119 doi "https://doi.org/10.1016/j.chest.2018.08.947" @default.
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