Table 2 Patient characteristics by PE-related clinical deterioration (primary outcome)*

Age, mean (SD)

62.3 (16.2)

62.2 (16.9)

62.2 (16.8)

0.93

Gender

 Male

134 (43.4%)

900 (49.7%)

1034 (48.8%)

0.154

 Female

175 (56.6%)

910 (50.3%)

1085 (51.2%)

Race

 American Indian/Alaskan Native

4 (1.3%)

19 (1.0%)

23 (1.1%)

0.02

 Black

129 (41.7%)

601 (33.2%)

730 (34.5%)

 Unknown

10 (3.2%)

37 (2.0%)

47 (2.2%)

 White

164 (53.1%)

1134 (62.7%)

1298 (61.3%)

 Asian

0 (0%)

6 (0.3%)

6 (0.3%)

 Other

1 (0.3%)

12 (0.7%)

13 (0.6%)

 Pacific Islander/Native Hawaiian

1 (0.3%)

1 (0.1%)

2 (0.1%)

Ethnicity

 Non-Hispanic/Latino

289 (93.5%)

1681 (92.9%)

1970 (93.0%)

 Hispanic/Latino

9 (2.9%)

45 (2.5%)

54 (2.5%)

0.69

 Unknown

11 (3.6%)

84 (4.6%)

95 (4.5%)

PE severity at PERT activation

 Non-severe submassive

39 (12.8%)

967 (53.4%)

1006 (47.5%)

< 0.001

 Severe submassive

144 (46.7%)

801 (44.3%)

945 (44.6%)

 Massive

126 (40.5%)

42(2.3%)

168 (7.9%)

PE severity classification criteria available during ED phase of care

 RV dilation by CT (RV: LV ≥ 1.0)

232 (75.1%)

1464 (80.9%)

1696 (80.0%)

0.02

 RV dilatation by echocardiography

107 (34.6%)

450 (24.9%)

557 (26.3%)

< 0.001

 Initial cardiac arrest

74 (23.9%)

0 (0%)

74 (3.5%)

< 0.001

 Initial vasopressor use

114 (36.9%)

0 (0%)

114 (5.4%)

< 0.001

 Sustained hypotension (15 min or more)

98 (31.7%)

31 (1.7%)

129 (6.1%)

< 0.001

 Episodic hypotension (less than 15 min)

43 (13.9%)

83 (4.6%)

126 (5.9%)

< 0.001

 Sustained elevated shock index (> 1.0 for 15 min or more)

145 (46.9%)

252 (13.9%)

397 (18.7%)

< 0.001

 Hypoxia with respiratory distress

(< 92% on room air or supplemental oxygen)

206 (66.7%)

602 (33.3%)

808 (38.1%)

< 0.001

 Abnormal troponin

261 (84.5%)

1247 (68.9%)

1508 (71.2%)

< 0.001

 Abnormal brain natriuretic peptide

203 (65.7%)

1044 (57.7%)

1247 (58.8%)

0.003

PE risk factors

 Previous venous thromboembolism

63 (20.4%)

443 (24.5%)

506 (23.9%)

0.13

  Missing

1 (0.4%)

0 (0%)

1 (0.0%)

 Hospitalization within previous 4 weeks

74 (23.9%)

240 (13.3%)

314 (14.8%)

< 0.001

  Missing

1 (0.3%)

3 (0.2%)

4 (0.2%)

 Total Charlson index, mean (SD)

1.89 (2.37)

1.50 (2.20)

1.55 (2.23)

0.004

 Recent limb immobilization

26 (8.4%)

81 (4.5%)

107 (5.0%)

0.004

  Missing

1 (0.4%)

6 (0.3%)

7 (0.3%)

 Recent trauma within 6 weeks

17 (5.5%)

40 (2.2%)

57 (2.7%)

0.002

 Family history of veno-thromboembolism

17 (5.5%)

164 (9.1%)

181 (8.5%)

0.04

  Missing

1 (0.3%)

12 (0.7%)

13 (0.6%)

 Clotting disorder

10 (3.2%)

64 (3.5%)

74 (3.5%)

1.0

  Missing

1 (0.4%)

13 (0.7%)

14 (0.7%)

 Tobacco user

177 (57.3%)

1055 (58.3%)

1232 (58.1%)

1.0

  Missing

129 (42.4%)

771 (41.8%)

887 (41.9%)

 Known pulmonary hypertension

20 (6.5%)

82 (4.5%)

102 (4.8%)

0.15

 Chronic obstructive pulmonary disease

67 (21.7%)

309 (17.1%)

376 (17.7%)

0.107

 Renal disease

42 (13.6%)

193 (10.7%)

235 (11.1%)

0.14

  Missing

0 (0%)

1 (0.1%)

1 (0.0%)

 Congestive heart failure

37 (12.0%)

142 (7.8%)

179 (8.4%)

0.02

 Dementia

26 (8.4%)

126 (7.0%)

152 (7.2%)

0.34

 Hemiplegia or paraplegia

17 (5.5%)

25 (1.4%)

42 (2.0%)

< 0.001

 Malignant leukemia or localized tumor

33 (10.7%)

213 (11.8%)

246 (11.6%)

0.63

 AIDS

3 (1.0%)

9 (0.5%)

12 (0.6%)

0.40

 Metastatic solid tumor

29 (9.4%)

154 (8.5%)

183 (8.6%)

0.59

Breakdown of clinical deterioration events during hospitalization (primary outcome)

 Cardiac arrest

125 (40.5%)

0 (0%)

125 (5.9%)

< 0.001

 Need for mechanical or positive pressure ventilation

198 (64.1%)

0 (0%)

198 (9.3%)

< 0.001

 Use of vasoactive medication

207 (67.0%)

0 (0%)

207 (9.8%)

< 0.001

 PE-related death

125 (45.1%)

0 (0%)

125 (5.9%)

< 0.001

Total NEWS2, mean (SD), points (Range: 0 to 20 points)

6.0 (3.3)

3.0 (2.4)

3.4 (2.8)

< 0.001

NEWS2 components

 Initial systolic blood pressure, mean (SD), mmHg

118 (29.5)

133 (23.4)

130 (24.9)

< 0.001

  Missing

1 (0.4%)

0 (0%)

1 (0.0%)

 Initial heart rate, mean (SD), beats per minute

109 (23.4)

103 (21.0)

104 (21.4)

< 0.001

  Missing

1 (0.4%)

0 (0%)

1 (0.0%)

 Initial respiratory rate, mean (SD), breaths/minute

23.7 (8.09)

20.7 (5.27)

21.1 (5.86)

< 0.001

  Missing

1 (0.4%)

0 (0%)

1 (0.0%)

 Temperature, mean (SD), degrees Fahrenheit

98.0 (1.35)

98.2 (0.71)

98.2 (0.828)

< 0.001

  Missing

26 (9.5%)

34 (1.8%)

60 (2.8%)

 Initial oxygen pulse oximetry, mean (SD), %

91.5 (11.2)

94.8 (5.29)

94.3 (6.59)

< 0.001

  Missing

2 (0.7%)

1 (0.1%)

3 (0.1%)

 Hypercapnic respiratory failure

0 (0%)

2 (0.1%)

2 (0.1%)

1.0

 Supplemental oxygen use

172 (56.6%)

472 (26.0%)

644 (30.4%)

< 0.001

 Altered mental status

  Alert

238 (77.0%)

1761 (97.3%)

1999 (94.3%)

< 0.001

  New confusion/altered mental status

71 (23.0%)

49 (2.7%)

120 (5.7%)

NEWS2 cut-off of 3

 < 3

41 (13.5%)

870 (47.9%)

911 (43.0%)

< 0.001

 ≥ 3

263 (86.5%)

945 (52.1%)

1208 (57.0%)

NEWS2 cut-off of 4

 < 4

74 (24.3%)

1130 (62.3%)

1204 (56.8%)

< 0.001

 ≥ 4

230 (75.7%)

685 (37.7%)

915 (43.2%)

NEWS2 cut-off of 5

 < 5

109 (35.9%

1346 (74.2%)

1455 (68.7%)

< 0.001

 ≥ 5

195 (64.1%)

469 (25.8%)

664 (31.3%)

Advanced PE intervention (secondary outcome)

163 (52.8%)

325 (18.0%)

488 (23.0%)

< 0.001

 Systemic thrombolysis

95 (30.7%)

101 (5.6%)

196 (9.2%)

< 0.001

 Catheter-directed intervention

41 (13.3%)

169 (9.3%)

210 (9.9%)

0.05

 Surgical embolectomy

9 (2.9%)

1 (0.1%)

10 (0.5%)

< 0.001

 Right ventricular assist device

0 (0%)

0 (0%)

0 (0%)

1.0

 Extracorporeal membrane oxygenation

13 (4.2%)

0 (0%)

13 (0.6%)

< 0.001

 Other

1 (0.3%)

4 (0.2%)

5 (0.2%)

0.499

Intensive care unit admission

267 (86.4%)

866 (47.8%)

1133 (53.5%)

< 0.001

Hospital length of stay, mean (SD), days

9.9 (16.6)

5.1 (9.6)

5.8 (11.0)

< 0.001