Integrating Pulmonary Embolism Response Teams (PERT): Perspectives and Outcomes from a German Survey Analysis

https://doi.org/10.1007/s00392-025-02625-4

Lukas Hobohm (Mainz)1, K. Keller (Mainz)2, I. Farmakis (Mainz)3, T. Tichelbäcker (Köln)4, M. Knorr (Mainz)2, I. Sagoschen (Mainz)1, C. A. Perings (Lünen)5, P. Lurz (Mainz)2, S. Konstantinides (Mainz)3, I. Ahrens (Köln)6

1Universitätsmedizin der Johannes Gutenberg-Universität Mainz Zentrum für Kardiologie Mainz, Deutschland; 2Universitätsmedizin der Johannes Gutenberg-Universität Mainz Kardiologie 1, Zentrum für Kardiologie Mainz, Deutschland; 3Universitätsmedizin der Johannes Gutenberg-Universität Mainz Centrum für Thrombose und Hämostase Mainz, Deutschland; 4Universitätsklinikum Köln Klinik III für Kardiologie, Angiologie, Pneumologie und Internistische Intensivmedizin Köln, Deutschland; 5KLW St. Paulus GmbH Medizinische Klinik I Lünen, Deutschland; 6Krankenhaus der Augustinerinnen, Akademisches Lehrkrankenhaus Klinik für Kardiologie und internistische Intensivmedizin Köln, Deutschland

 

Background
In recent years, the establishment of multidisciplinary pulmonary embolism response teams (PERTs) has become more prevalent in response to the growing challenges in managing acute pulmonary embolism (PE). A survey was conducted to assess the availability and structure of PERTs in German hospitals.

Methods
A survey was circulated among German hospital centers with cardiovascular expertise to obtain data on their current PE treatments, the existence and features of PERTs, their activation methods, and their structural organization. Additionally, data regarding PE treatment priority relative to acute coronary syndrome and the availability of outpatient PE follow-up programs was collected. Additionally, the results were compared to a previous survey in Europe among PE reference centers.

Results
Overall, 65 hospitals participated at this German survey with most PERTs available at university hospitals (63%) and in West (63%) and Southern (62%) Germany (Figure 1C und 1D). Although 61.5% of the German centers handle over 40 PE cases annually, only 52.3% of those hospitals already implemented a PERT, which is low in comparison to a European Survey among PE reference centers (80.8%) (Figure 1A). The most common method of activating PERTs is through phone calls (71.1%), followed by mobile apps (23.7%) and pagers (5.2%). In 86% cases, PERT is leading from the Department of Cardiology followed by Pulmonology (4.6%), Critical Care Medicine (2.3%) followed by Angiology (6.9%). Regarding advanced treatment the majority of hospitals offers catheter-directed thrombolysis (72.2%) and catheter-based thrombectomy/aspiration (74.1%). Notably, almost half of the centers (49.6%) prioritize ST-elevation infarction over high-risk PE. The follow-up of patients with PE is organized in 7.8% in a dedicated PE clinic, in 26.6%in the clinic of the physician leading PERT and in 57.8% no PE follow-up is available. In the European survey, only 7.7% stated that no PE follow-up is present (Figure 1B).

Conclusion
This survey demonstrated that among large German cardiovascular centers PERTs are markedly less often present compared to European PE reference centers. Additionally, in German centers, PE follow-up program are not widely implemented. This emphasizes the pressing need for awareness campaigns to enlighten physicians about the significant mortality rates and longterm sequelae linked with PE.

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