High-risk PE patients have high mortality rates among patients with hemodynamic collapse

In a recent study from the Pulmonary Embolism Response Team (PERT) Consortium Registry found the contemporary care patterns and outcomes for high-risk pulmonary embolism (PE) patients. The findings of the study were published in the Journal of the American College of Cardiology.

This research comprised a total of 5,790 patients by meticulously categorizing the individuals who present with intermediate-risk PE, high-risk PE, and catastrophic PE and involved cases with hemodynamic collapse.

1,442 out of the total patients in the study presented with high-risk PE showed that advanced therapies were more frequently employed in this subgroup compared to those with intermediate-risk PE. But, the ground reality unveiled a high in-hospital mortality rates (20.6%) and a higher incidence of major bleeding (10.5%) in PE patients with high-risk. The factors like the use of vasopressor, extracorporeal membrane oxygenation utilization, clot-in-transit identification and malignancy emerged as major important contributors to the in-hospital mortality.

Also, catastrophic PE patients constituted to 13.7% of high-risk PE cases and they faced even graver outcomes with significantly higher in-hospital mortality rates (42.1%). The extracorporeal membrane oxygenation and systemic thrombolysis were more commonly utilized in the cases of catastrophic PE.

This study highlights the urgent need for enhanced strategies in managing high-risk PE patients. With mortality rates reaching alarming levels specially in the catastrophic cases. This findings of this study call for a reevaluation of the current practices and the development of interventions that are more effective to improve outcomes in patients.

Reference:

Kobayashi, T., Pugliese, S., Sethi, S. S., Parikh, S. A., Goldberg, J., Alkhafan, F., Vitarello, C., Rosenfield, K., Lookstein, R., Keeling, B., Klein, A., Gibson, C. M., Glassmoyer, L., Khandhar, S., Secemsky, E., & Giri, J. (2024). Contemporary Management and Outcomes of Patients With High-Risk Pulmonary Embolism. In Journal of the American College of Cardiology (Vol. 83, Issue 1, pp. 35–43). Elsevier BV. https://doi.org/10.1016/j.jacc.2023.10.026