• Pulmonary Embolism Response Team (PERT) ▸

PERTPulmonary Embolism Response Team

Methodist Heart and Lung Institute’s PERT was established in 2018 to address PE, a life-threatening condition that can occur without warning. The Centers for Disease Control and Prevention estimate that as many as 100,000 people in the U.S. die from deep vein thrombosis and pulmonary embolisms each year. The morbidity and mortality rates are dramatic. For example, sudden death is the first symptom of a PE about 25 percent of the time.1 Many of the people with PE are younger adults with no significant history of cardiovascular disease.

1 U.S. Centers for Disease Control and Prevention. Data and Statistics on Venous Thromboembolism. Retrieved from https://www.cdc.gov/ncbddd/dvt/data.html. Accessed December 7, 2021.

Despite the condition’s prevalence and seriousness, there is a lack of standardized protocols and evidence-based best practices nationwide. There are several reasons for this. First, PE presents in a wide variety of ways, potentially delaying diagnosis. Second, treatment options for PE vary, from medical treatment with anticoagulants for submassive PE all the way to ECMO for massive pulmonary embolization. The solution to these challenges is the development of standard protocols based on reliable data. PERT’s dataset will help to create national guidelines for risk stratification and standard treatment protocols. Methodist Heart and Lung Institute is taking a leadership role in improving standardization and protocols for PE care. The approach to patients with pulmonary embolisms begins with a standardized assessment of the basic clinical variables of each patient who is admitted to the hospital with this condition. Next, the team uses a scoring system to determine each patient’s clinical risk and best treatment option. Finally, PERT tracks the patient throughout hospitalization and after discharge, collecting outcomes and readmission data. Methodist Heart and Lung Institute’s pulmonary and critical care team has large patient volumes, rendering the hospital’s patient data especially useful for researchers. Whereas other facilities may only see a handful of PEs a year, our program sees 200-300 a year. Additionally, Methodist Heart and Lung Institute has a robust ECMO program, giving the hospital the capability to care for patients with massive PE. Our system of care interacts with the ECMO team, informing them of any patient who presents with a PE. Working as one multidisciplinary team, PERT and ECMO experts follow each patient from admission to discharge. PERT Pulmonary Embolism Response Team

Charles Burch, md

Director, Cardiovascular Intensive Care Unit (CVICU), Methodist Hospital

PE is a common, dangerous condition that is garnering national attention. One particular challenge of treating this condition is that it can be difficult to diagnose. Time to diagnosis and time to treatment are important indicators of whether a given patient will survive a PE. Having well-organized, standard diagnostic and treatment protocols in place can significantly improve outcomes for patients with PE, while also decreasing readmission rates.

In 2022, the PERT team will expand our program to examine data across Methodist Healthcare. This will enable us to determine the best systemwide approach to PE diagnosis and treatment. We aim to continue making improvements to our dataset, enabling us to extract more sophisticated and detailed information that will inform protocol development.

Our vision is that PE identification and treatment will become as standardized, and as successful, as heart attack care is today. The database we are creating of PE patients across the Methodist Healthcare system will become the basis of a model for effective PE management at HCA hospitals nationwide.