Initial impact of a multidisciplinary pulmonary embolism response team on patients with intermediate- to high-risk pulmonary embolism

Acute pulmonary embolism represents a major form of pulmonary vascular disease associated with significant morbidity and mortality. Pulmonary Embolism Response Teams (PERTs) have been increasingly implemented to improve the management of intermediate- and high-risk pulmonary embolism (PE). However, evidence regarding their impact in Spain remains limited. To evaluate the clinical and organizational impact of implementing a multidisciplinary PERT in a tertiary university hospital in Spain, focusing on in-hospital mortality, treatment strategies, bleeding complications and length of stay. We conducted a retrospective observational before-and-after study of consecutive eligible episodes of confirmed intermediate-high- or high-risk acute PE between 1 January 2022 and 31 January 2025. The pre-PERT period was 1 January 2022 to 31 March 2023 and the post-PERT period was 1 April 2023 to 31 January 2025. Clinical characteristics, biomarkers, management and in-hospital outcomes were compared using unadjusted analyses. Forty-two eligible PE episodes in 41 individual patients were included (17 pre-PERT and 25 post-PERT). In-hospital mortality was numerically lower after PERT implementation (6/17 [35.3%] vs. 3/25 [12.0%]; odds ratio [OR] 0.25, 95% CI 0.05–1.19; p = 0.124), although the difference was not statistically significant. Major bleeding was less frequent in the post-PERT period (5/17 [29.4%] vs. 0/25 [0%]; p = 0.007). Systemic thrombolysis, catheter-directed thrombolysis and mechanical thrombectomy were used less frequently after PERT implementation, while ICU and hospital length of stay showed no statistically significant differences. The cohorts showed differences in selected severity markers, including higher hs-troponin T in the post-PERT group, but overall ESC risk-group distribution was similar. In this small retrospective before-and-after cohort, PERT implementation was associated with fewer major bleeding events and a substantial but statistically non-significant numerical reduction in in-hospital mortality. These findings are hypothesis-generating and should not be interpreted as evidence of a causal effect. Larger prospective multicenter studies are required. Not applicable. In-hospital mortality was numerically lower after PERT implementation, but the difference was not statistically significant. Major bleeding was significantly less frequent in the post-PERT period. Advanced reperfusion therapies were used less frequently after PERT implementation in this single-center cohort. The small retrospective before-and-after design makes the findings hypothesis-generating and precludes causal inference. Future larger multicenter studies are needed to confirm the impact of PERT models on outcomes.