Evaluation of risk factors for adverse outcome in extracorporeal membrane oxygenation-supported elderly postcardiotomy patients
- 1 May 2020
- journal article
- conference paper
- Published by SAGE Publications in Perfusion
- Vol. 35 (1_suppl), 50-56
- https://doi.org/10.1177/0267659120907746
Abstract
Background: Recently extracorporeal membrane oxygenation is becoming the commonly used mechanical assist device for the treatment of severe cardiogenic shock in postcardiotomy patients. Evaluation of risk factors of negative outcome would be beneficial in decision-making in the elderly patient population. Methods: This was a retrospective single-centre analysis of elderly patients who underwent extracorporeal membrane oxygenation treatment for refractory cardiogenic shock in a tertiary care centre. Demographic data, comorbidities and perioperative parameters were collected to evaluate their impact on the outcome of extracorporeal membrane oxygenation treatment in this patient group. Logistic regression analysis of the variables was performed to identify factors predicting an adverse outcome. Results: Forty consecutive elderly patients underwent extracorporeal membrane oxygenation treatment during the study period. The mean age was 76.73.8years, 27 (68%) were male. The mean Survival after Veno-Arterial extracorporeal membrane oxygenation score before initiating extracorporeal membrane oxygenation support was - 11 +/- 6. Intra-aortic counterpulsation was used as the first-line mechanical support in 31 (77%) patients. The mean duration of extracorporeal membrane oxygenation support was 172 +/- 128hours. Twenty-four patients (56%) were successfully weaned from extracorporeal membrane oxygenation, and 8 (20%) survived to hospital discharge. Lactate level before extracorporeal membrane oxygenation initiation was the only predictor of unfavourable outcome in multivariate analysis (p<0.05). Conclusion: High lactate level before initiation of extracorporeal membrane oxygenation was the most important prognostic values of an unfavourable outcome.This publication has 20 references indexed in Scilit:
- Extracorporeal Membrane Oxygenation Support in Postcardiotomy Elderly Patients: The Mayo Clinic ExperienceThe Annals of Thoracic Surgery, 2015
- The impact of frailty on outcomes after cardiac surgery: A systematic reviewThe Journal of Thoracic and Cardiovascular Surgery, 2014
- Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic ShockThe New England Journal of Medicine, 2012
- EuroSCORE IIEuropean Journal of Cardio-Thoracic Surgery, 2012
- Outcomes, long-term quality of life, and psychologic assessment of fulminant myocarditis patients rescued by mechanical circulatory support*Critical Care Medicine, 2011
- Gait Speed as an Incremental Predictor of Mortality and Major Morbidity in Elderly Patients Undergoing Cardiac SurgeryJournal of the American College of Cardiology, 2010
- Clinical review: Practical recommendations on the management of perioperative heart failure in cardiac surgeryCritical Care, 2010
- How should age affect management of acute myocardial infarction? A prospective cohort studyThe Lancet, 1999
- Intermittent antegrade warm blood cardioplegiaThe Annals of Thoracic Surgery, 1995
- A New Simplified Acute Physiology Score (SAPS II) Based on a European/North American Multicenter StudyJAMA, 1993