A67-15 Impact of Initiation of a Pulmonary Embolism Response Team (PERT) on Outpatient Pulmonary Follow-up

Abstract Rationale Pulmonary Embolism Response Teams (PERT) provide in-hospital risk stratification and management of acute pulmonary embolism (PE). Despite acute treatment for PE, many patients experience long-term complications, ranging from persistent dyspnea and functional limitations to chronic thromboembolic disease (CTED) and chronic thromboembolic pulmonary hypertension (CTEPH). Data is limited on how PERT contributes to the detection of these conditions post hospitalization. We aimed to assess the impact of implementing a PERT at our academic medical center on dedicated pulmonary follow-up after an acute PE. We conducted a retrospective review of patients with acute intermediate and high-risk PE, before and after PERT implementation, and compared outpatient follow-up rates, cardiopulmonary testing obtained, and the incidence of post-PE complications in these two groups. Methods This study utilized an observational, pre-post intervention design. The intervention was incorporating a referral to the outpatient pulmonary clinic as part of PERT consults in patients with acute intermediate or high-risk PE. Fellows received training on the PERT protocol and the referral process at the start of PERT implementation and annually during fellowship orientation. The intervention began on May 21, 2021. Patient data were analyzed two years before (May 2019 to April 2021) and two years after PERT implementation (May 2021 to April 2023). Pre-PERT cases were identified using data extraction from the electronic medical records, while post-PERT cases were identified from the list of PERT activations. All cases were from the University of Vermont Medical Center. Statistical analyses were performed using descriptive statistics, including percentages and means, and comparisons between groups were conducted using t-test and chi-square test. Results The study included 162 cases pre-PERT and 119 cases post-PERT. Following PERT implementation, the rate of outpatient pulmonary clinic follow-up increased significantly from 28.4% to 51.3% (p < 0.001). The mean time to the first clinic visit decreased from 91 days to 58 days (p < 0.001). The most common reason for lack of follow-up was absence of referral, occurring in 80.3% of pre-PERT cases and 51.7% of post-PERT cases. Both groups demonstrated similar rates of persistent dyspnea, utilization of diagnostic testing for dyspnea evaluation, and incidence of CTED. No cases of CTEPH were identified in either group. Conclusion Implementation of a PERT at our academic medical center was associated with a significant increase in timely outpatient follow-up after an acute PE. Incorporating pulmonary clinic referral as part of the PERT evaluation may facilitate earlier identification and management of long-term complications after PE. This abstract is funded by: None