Abstract
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.