[Modern therapy of pulmonary embolism with PERT and EKOS: an advantage also for in-hospital time?]

Today, patients with intermediate high-risk pulmonary embolism are usually treated by a pulmonary embolism response team (PERT) and often EKOS lysis. We investigated whether this approach leads to a reduction in the hospital stay duration.

A retrospective analysis of patients with intermediate high-risk pulmonary embolism clinically assessed by PERT and treated with EKOS lysis in a medical intensive care unit (ICU) between 01 October 2021 and 21 August 2024 was undertaken. The control group comprised patients suffering from intermediate high-risk pulmonary embolism, treated with medication alone (without assessment by PERT) in the ICU between 01 January 2010 and 31 December 2021. The economic/process-associated endpoint of the study was duration of hospital stay (days in hospital).

A total of 45 patients were treated in the EKOS and PERT group and 31 in the control group. No differences regarding sex, vital signs, and laboratory parameters were observed. Despite the higher age of patients in the group treated by PERT and EKOS (64.7 years [53.4-71.6] vs. 54.0 years [38.6-63.1], *p = 0.03), the duration of hospital stay was significantly shorter (7.8 days [5.2-13.2] vs. 12.9 days [7.1-22.1], *p = 0.003). Time in the ICU was also significantly shorter (0.9 days for PERT and EKOS [0.5-1.5] vs. 2.0 days [0.9-6.2], *p = 0.01).

In addition to being advantageous in situations where there is a shortage of acute care beds, a reduction of hospital stay may also potentially reduce treatment costs. This is especially important in ageing societies like Germany suffering from constantly increasing healthcare costs.