دورية أكاديمية
Interhospital Transfer for the Management of Acute Pulmonary Embolism.
| العنوان: | Interhospital Transfer for the Management of Acute Pulmonary Embolism. |
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| المؤلفون: | Carroll BJ; Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass; Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. Electronic address: Bcarrol2@bidmc.harvard.edu., Beyer SE; Division of Cardiology, New York-Presbyterian/Cornell Medical Center, Weill Cornell Medical College, New York City, NY., Shanafelt C; Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass., Kabrhel C; Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass., Rali P; Division of Pulmonology, Temple University Hospital, Lewis Katz School of Medicine at Temple University, Philadelphia, Penn., Rivera-Lebron B; Division of Pulmonology, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, Penn., Rosovsky R; Division of Hematology and Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Mass., Ross CB; Piedmont Heart Institute, Piedmont Atlanta Hospital, Atlanta, Ga., Pinto DS; Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass., Secemsky EA; Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass; Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass. |
| المصدر: | The American journal of medicine [Am J Med] 2022 Apr; Vol. 135 (4), pp. 531-535. Date of Electronic Publication: 2021 Dec 24. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0267200 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1555-7162 (Electronic) Linking ISSN: 00029343 NLM ISO Abbreviation: Am J Med Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Excerpta Medica Original Publication: New York, Donnelly. |
| مواضيع طبية MeSH: | Pulmonary Embolism*, Acute Disease ; Humans ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers ; Thrombolytic Therapy/adverse effects ; Treatment Outcome |
| مستخلص: | Background: There are increasing treatment options for the management of acute pulmonary embolism (PE), though many are only available at tertiary care centers. Patients with acute pulmonary embolism with high-risk features are often transferred for consideration of such therapies. There are limited data describing outcomes in patients transferred with acute pulmonary embolism. Methods: We evaluated patients with acute pulmonary embolism at our tertiary care center from August 2012 through August 2018 and compared clinical characteristics, pulmonary embolism features, management, and outcomes in those transferred for acute pulmonary embolism to those that were not transferred. Results: Of 2050 patients with pulmonary embolism included in the study, 432 (21.1%) were transferred from an outside hospital with a known diagnosis of pulmonary embolism. Patients transferred had a lower rate of malignancy (22.2% vs 33.3%; P < .001) and median Charlson comorbidity index (3 vs 4; P < .001). A higher percentage of patients transferred were classified as intermediate- or high-risk pulmonary embolism (62.5% vs 43.0%; P <.001) and more frequently received advanced therapy beyond anticoagulation alone (12.5% vs 3.2%, P < .001). Overall survival to discharge was similar between groups, though definite pulmonary embolism-related mortality was higher in the transferred group (38.5% vs 9.4%, P = .004). Conclusion: More than 1 in 5 patients treated for acute pulmonary embolism at a tertiary care center were transferred from an outside facility. Transferred patients had higher risk pulmonary embolism features, more often received advanced therapy, and had higher definite pulmonary embolism-related mortality. There are opportunities to further optimize outcomes of patients transferred for management of acute pulmonary embolism. (Copyright © 2021 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Interhospital transfer; Pulmonary embolism; Thrombolysis |
| تواريخ الأحداث: | Date Created: 20211226 Date Completed: 20220411 Latest Revision: 20220705 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.amjmed.2021.11.015 |
| PMID: | 34954228 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1555-7162 |
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| DOI: | 10.1016/j.amjmed.2021.11.015 |