(1061) Long-Term Outcomes Associated With a Pulmonary Embolism Response Team: A Retrospective Cohort Study

Introduction: Pulmonary embolism (PE) is a high-risk condition with long-term sequelae. Post-PE guidelines recommend PE-specific follow within 3 months of discharge for discussion of anticoagulation and further evaluation. Recently there has been growing interest in the use of pulmonary embolism response teams (PERTs) to improve the management of PE, but research has focused on acute outcomes. The impact of PERT consultation on long-term outcomes remains unknown. This study tested the hypothesis that PERT consult is associated with greater rates of linkage to appropriate follow-up, mediating improvement in long-term outcomes among PE patients.

Methods: We conducted a propensity-matched retrospective cohort study of intermediate or high-risk PE patients admitted to a quaternary center between 4/1/2019-4/1/2021, evaluating associations between PERT consultation and clinical outcomes between discharge and 04/30/2023. Outcomes included rates of PE clinic referral and attendance after discharge, guideline-recommended evaluation of anticoagulation therapy, bleeding complications, hospital readmission, VTE recurrence, all-cause mortality, and CTEPH and CTED diagnoses.

Results: In propensity-matched analyses, the odds ratio (OR) for follow-up referral among PERT consult recipients (PCs) was 11.8 (6.6 – 21.2, P< 0.001) compared to non-recipients (NPCs). The OR for follow-up visit attendance was 5.14 (2.51 – 10.5, P< 0.001). The OR for follow-up discussion of anticoagulation was 2.63 (1.5 – 4.6, P< 0.001). There was no association between PERT consultation and bleeding complications (OR 1.19, 0.4 – 3.5, P = 0.75) or readmission(OR 0.91, 0.54 – 1.56, P = 0.74). There was a borderline-significant trend towards a greater likelihood of VTE recurrence among PCs (OR 3.8, 0.99 – 14.8, P = 0.05). There was a significant difference in 1-year mortality (OR 0.27, 0.12 – 0.59, P = 0.001) and over the follow-up period (OR 0.63, 0.39 – 0.99, P = 0.47). Kaplan-Meier analysis showed a significant difference in mortality (P = 0.001), with a HR of 0.44 (0.003).

Conclusions: These findings suggest PERT consultation may improve follow-up and long-term outcomes in patients with intermediate or high-risk PE. However, further research is needed to confirm these findings and to determine the optimal role of PERTs in the management of PE.