Patient Demographics and Extracorporeal Membranous Oxygenation (ECMO)-Related Complications Associated With Survival to Discharge or 30-Day Survival in Adult Patients Receiving Venoarterial (VA) and Venovenous (VV) ECMO in a Quaternary Care Urban Center.
J Cardiothorac Vasc Anesth
; 33(4): 910-917, 2019 04.
Article
en En
| MEDLINE
| ID: mdl-30245110
ABSTRACT
OBJECTIVE:
Investigate how a multitude of patient demographics and extracorporeal membranous oxygenation (ECMO)-related complications affect 30-day survival or survival to discharge.DESIGN:
Retrospective observational study.SETTING:
Urban university hospital, quaternary care center.PARTICIPANTS:
Patients who underwent ECMO circulatory support from January 2012 to May 2016.INTERVENTIONS:
Date-based data extraction, univariate and multivariate regression analysis. MEASUREMENTS AND MAINRESULTS:
The hospital database contained complete data for 235 adult patients who received venoarterial ECMO (74.04 %) and venovenous ECMO (25.96 %); 106 patients (45.11%) survived. The independent predictors significant in the odds of in-hospital mortality in a multiregression model were age (odds ratio [OR]â¯=â¯1.028, pâ¯=â¯0.008), extracorporeal cardiopulmonary resuscitation (ECPR) after unsuccessful high-quality CPR (ORâ¯=â¯7.93, p =0.002), cardiogenic shock as the primary indication for circulatory support (ORâ¯=â¯2.58, pâ¯=â¯0.02), acute kidney injury (AKI) before ECMO initiation (ORâ¯=â¯7.53, p < 0.001), time spent on ECMO in days (ORâ¯=â¯1.08, pâ¯=â¯0.03), and limb ischemia (ORâ¯=â¯3.18, pâ¯=â¯0.047).CONCLUSION:
The most significant findings of advancing age, time spent on ECMO, AKI, ECMO use in the setting of cardiogenic shock, ECPR, and limb ischemia as a complication of ECMO all independently increase the odds of in-hospital and 30-day mortality. To the best of the authors' knowledge, this study is the first to demonstrate a significant relationship between limb ischemia and mortality.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Alta del Paciente
/
Hospitales Urbanos
/
Oxigenación por Membrana Extracorpórea
/
Hemofiltración
/
Mortalidad Hospitalaria
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Asunto de la revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Año:
2019
Tipo del documento:
Article