Effect of Hospital Volume on Outcome of Extracorporeal Membrane Oxygenation Supportã- Nationwide Population-Based Cohort Study in Taiwan.
Circ J
; 87(5): 600-607, 2023 04 25.
Article
en En
| MEDLINE
| ID: mdl-36223943
ABSTRACT
BACKGROUND:
In modern critical care, extracorporeal membrane oxygenation (ECMO) is crucial in the management of severe respiratory and cardiac failure. Nationwide studies of the relationship between hospital volume and outcomes of ECMO use are unavailable.MethodsâandâResults:
Using Taiwan's National Health Insurance Research Database, we identified 11,734 adult patients who received ECMO support in 101 hospitals between January 1, 2001, and December 31, 2017. Outcomes included in-hospital mortality, 1-year mortality, and ECMO-related complications. Cox proportional hazards model, locally estimated scatterplot smoothing, and restricted cubic spline regression were used to analyze the volume-outcome relationship. The overall in-hospital mortality rate was 65.5%, and the 1-year mortality rate was 70.6% in this database. The 101 hospitals were divided into 4 groups based on annual volume. The in-hospital and 1-year mortality rates were significantly lower in the high-volume group (annual volume >40) than in the low-volume group (annual volume <10).CONCLUSIONS:
For critical care, high-volume hospitals have superior short-term and mid-term outcomes. To make the medical system equitable and reasonable, establishing a rapid and efficient nationwide referral system should be considered.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Oxigenación por Membrana Extracorpórea
Tipo de estudio:
Etiology_studies
/
Observational_studies
Límite:
Adult
/
Humans
País/Región como asunto:
Asia
Idioma:
En
Año:
2023
Tipo del documento:
Article