The IMPACT Score: A New Score to Predict the Risk of Early Mortality in Cardiogenic Shock Patients Treated With Venoarterial Extracorporeal Membrane Oxygenation.
J Cardiothorac Vasc Anesth
; 38(2): 451-458, 2024 Feb.
Article
de En
| MEDLINE
| ID: mdl-38185567
ABSTRACT
OBJECTIVES:
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) requires considerable human and financial resources. Few studies have focused on early mortality (ie, occurring within 72 hours after VA-ECMO implantation). The objective of this study was to establish a prognosis score-the IMPACT score (prediction of early mortality associated with VA-ECMO using preimplantation characteristics)-by determining the risk factors associated with early mortality.DESIGN:
This was a retrospective and observational study.SETTING:
The study was conducted at a University hospital.PARTICIPANTS:
This single-center retrospective study included 147 patients treated with VA-ECMO for cardiogenic shock between 2014 and 2021.METHODS:
The primary outcome was early mortality (ie, occurring within 72 hours after VA-ECMO implantation). Multivariate logistic regression was performed using a bootstrapping methodology to identify factors independently associated with early mortality. To construct the score, identified variables had points (pts) assigned corresponding to their odds ratio.RESULTS:
A total of 147 patients were included in the study. Early mortality (<72 hours) was 26% (38 patients). Four variables were established cardiac arrest (2 pts), lactate levels (3 pts), platelet count <100 g/L (4 pts), and renal-replacement therapy (5 pts). The IMPACT score had an area under the receiver operating characteristic curve of 0.78 (95% CI 0.86-0.70) to predict early mortality.CONCLUSIONS:
In the authors' experience, 26% of patients treated with VA-ECMO presented early mortality. The IMPACT score is a reliable predictor of early mortality and may assist with VA-ECMO initiation decision-making.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Oxygénation extracorporelle sur oxygénateur à membrane
/
Arrêt cardiaque
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Humans
Langue:
En
Journal:
J Cardiothorac Vasc Anesth
Sujet du journal:
ANESTESIOLOGIA
/
CARDIOLOGIA
Année:
2024
Type de document:
Article
Pays d'affiliation:
France
Pays de publication:
États-Unis d'Amérique