Comparison of Treatment Approaches and Subsequent Outcomes within a Pulmonary Embolism Response Team Registry

Table 1

Patient characteristics and outcomes by primary outcome (treatment approach).

Characteristics	Overall N = 1832	Anticoagulation monotherapy, N = 1440	Delayed advanced PE intervention (>12 hours) N = 113	Immediate advanced PE intervention (within 12 hours) N = 279	P value (difference by ANOVA or chi-square)
Demographics
Mean age, years (SD)	62.8 (16.0)	64.3 (15.9)	57.3 (14.8)	57.5 (15.5)	<0.001
Gender: cis male, n (%)	890 (48.6%)	690 (47.9%)	61.0 (54.0%)	139 (49.8%)	0.438
Gender: cis female, n (%)	942 (51.4%)	750 (52.1%)	52.0 (46.0%)	140 (50.2%)
Race, n (%)
Caucasian	1125 (61.4%)	891 (61.9%)	70 (61.9%	164 (58.8%)	0.713
African-American	642 (35.0%)	492 (34.2%)	40 (35.4%)	110 (39.4%)
American-Indian/Alaskan	16 (0.9%)	15 (1.0%)	1 (0.9%)	0 (0%)
Asian	5 (0.3%)	4 (0.3%)	0 (0%)	1 (0.4%)
Pacific Islander	1 (0.1%)	1 (0.1%)	0 (0%)	0 (0%)
Other	9 (0.5%)	9 (0.6%)	0 (0%)	0 (0%)
Missing	34 (1.9%)	28 (1.9%)	2 (1.8%)	4 (1.4%)
Ethnicity, n (%)
Hispanic	43 (2.3%)	35 (2.4%)	1 (0.9%)	7 (2.5%)	0.799
Non-Hispanic	1704 (93.0%)	1336 (92.8%)	106 (93.8%)	262 (93.9%)
Other	85 (4.6%)	69 (4.8%)	6 (5.3%)	10 (3.6%)
Initially eligible for advanced PE intervention, n (%)
Yes	855 (46.7%)	564 (39.2%)	71 (62.8%)	220 (78.9%)	<0.001
No	977 (53.3%)	876 (60.8%)	42 (37.2%)	59 (21.1%)
PE severity at presentation^†n (%)
High risk	139 (7.6%)	53 (3.7%)	7 (6.2%)	79 (28.3%)	<0.001
Intermediate-high risk	707 (38.6%)	512 (35.6%)	62 (54.9%)	133 (47.7%)
Intermediate-low risk	977 (53.3%)	868 (60.3%)	44 (38.9%)	65 (23.3%)
Low risk	9 (0.5%)	7 (0.5%)	0 (0%)	2 (0.7%)
Bleeding risk assessment, n (%)
High	248 (13.5%)	200 (13.9%)	21 (18.6%)	27 (9.7%)	<0.001
Moderate	915 (49.9%)	748 (51.9%)	42 (37.2%)	125 (44.8%)
Low	669 (36.5%)	492 (34.2%)	50 (44.2%)	127 (45.5%)
Initial PE severity/bleeding risk profile, n (%)
High PE/high bleeding risk	34 (1.9%)	17 (1.2%)	4 (3.5%)	13 (4.7%)	<0.001
High PE/moderate bleeding risk	62 (3.4%)	28 (1.9%)	1 (0.9%)	33 (11.8%)
High PE/low bleeding risk	43 (2.3%)	8 (0.6%)	2 (1.8%)	33 (11.8%)
Intermediate-high PE/high bleeding risk	113 (6.2%)	90 (6.3%)	12 (10.6%)	11 (3.9%)
Intermediate-high PE/moderate bleeding risk	355 (19.4%)	267 (18.5%)	22 (19.5%)	66 (23.7%)
Intermediate-high PE/low bleeding risk	239 (13.0%)	155 (10.8%)	28 (24.8%)	56 (20.1%)
Intermediate-low PE/high bleeding risk	101 (5.5%)	93 (6.5%)	5 (4.4%)	3 (1.1%)
Intermediate-low PE/moderate bleeding risk	494 (27.0%)	450 (31.3%)	19 (16.8%)	25 (9.0%)
Intermediate-low PE/low bleeding risk	391 (21.3%)	332 (23.1%)	20 (17.7%)	39 (14.0%)
Clinical outcomes
Death	39 (2.7%)	12 (10.6%)	43 (15.4%)	94 (5.1%)	<0.001
Clinical deterioration	98 (6.8%)	18 (15.9%)	102 (36.6%)	218 (11.9%)	<0.001

The percentages within each cell were calculated using the N in the column header for that cell (e.g., of all patients who received anticoagulation monotherapy, 53/1440 (3.7%) were classified as high-risk PE at ED presentation. Conversely, all 139 (38.1%) high-risk PE patients in this study had anticoagulation monotherapy). ^†We found the following proportions for each criterion used to determine PE severity: 81% had a RV : LV ratio of 1.0 or greater as determined by CT, 22% had RV dilatation by echocardiography, 3.2% arrived in cardiac arrest, 5.0% required vasopressor support at presentation, 5.6% had sustained hypotension, 5.2% had episodic hypotension, 17.8% had a sustained elevated shock index, 36.2% had hypoxia with respiratory distress at rest, 68% had elevated troponin, and 57.2% had elevated brain natriuretic peptide levels.