Pulmonary Embolism With Acute Cor Pulmonale
Conditions
Keywords
pulmonary embolism, pulmonary embolism response team,
Brief summary
Pulmonary embolism (PE) is the third leading cause of cardiovascular mortality. The Pulmonary Embolism Response Team (PERT) concept offers a rapid and multidisciplinary approach focused on improving outcomes for patients with PE. All institutionalized PERTs in Poland have been invited to join the study. The goal of this registry is to describe current practice and outcomes in patients with acute PE treated by Polish PERTs.
Detailed description
Pulmonary embolism (PE) is the third leading cause of cardiovascular mortality. The presentation of PE may vary from asymptomatic or mild exertion disturbances (low-risk PE) treated with anticoagulants only to hemodynamic obstructive collapse and death (high-risk PE). Patient outcome depends on ability of the right ventricle to sustain the increased afterload caused by the embolic burden. Careful risk stratification is crucial, and the Pulmonary Embolism Response Team (PERT) concept offers a rapid and multidisciplinary approach focused on improving outcomes for patients with PE by advancing its recognition, diagnosis, and treatment. All institutionalized PERTs in Poland have been invited to join the study. The data is administrated by the Poznan University of Medical Sciences on the basis of an agreement between the PERT centres. The goal of this registry is to describe current practice and outcomes in patients with acute PE guided by Polish PERTs. The primary data recorded include details of each patient's clinical status, co-morbidities, the administered treatment modalities, the results of additional studies (ab tests results, ECG, imaging studies), and the outcome. The data collection will have no impact on the way the patient is diagnosed and treated.The study endpoints comprise respiratory failure, shock, death distal systemic embolization (i.e. stroke) and major or minor bleeding complications classified according to the International Society on Thrombosis and Haemostasis classification.
Interventions
None listed
Sponsors
Polish Cardiac Society
Poznan University of Medical Sciences
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. PE confirmed by computed tomography pulmonary angiography. 2. PE symptoms duration ≤ 14 days. 3. High-risk PE with hemodynamic instability (one of): * cardiac arrest * obstructive shock * persistent hypotension. 4. Intermediate-high risk PE patients with right ventricle dysfunction confirmed by imaging studies and elevated troponin level.
Exclusion criteria
1\. Refusal to sign the informed consent form.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical improvement during hospitalization | 24 hours after specific PE treatment implementation | Incidence of arterial blood saturation increase \>92% |
| Ventricular strain reduction | 24 hours after specific PE treatment implementation | Rate of right ventricular strain reduction (right ventricle/left ventricle ratio assessment) in echocardiography |
| Early mortality rate from pulmonary embolism | Two weeks since PE diagnosis | Number of patients who died from pulmonary embolism (right heart failure) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total mortality rate from pulmonary embolism | 3 months since PE diagnosis | Number of patients who died from pulmonary embolism (right heart failure) |
| Bleeding events incidence | 3 months since PE diagnosis | Incidence of major bleedings assessed using ISTH criteria |
Countries
Poland
Contacts
Primary ContactAleksander Araszkiewicz
Backup ContactSylwia Sławek-Szmyt
Outcome results
None listed