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- Title
Predictors of in-hospital mortality after successful weaning of venoarterial extracorporeal membrane oxygenation in cardiogenic shock.
- Authors
Jeong, Joo Hee; Kook, Hyungdon; Lee, Seung Hun; Joo, Hyung Joon; Park, Jae Hyoung; Hong, Soon Jun; Kim, Mi-Na; Park, Seong-Mi; Jung, Jae Seung; Yang, Jeong Hoon; Gwon, Hyeon-Cheol; Ahn, Chul-Min; Jang, Woo Jin; Kim, Hyun-Joong; Bae, Jang-Whan; Kwon, Sung Uk; Lee, Wang Soo; Jeong, Jin-Ok; Park, Sang-Don; Lim, Seong-Hoon
- Abstract
Limited knowledge exists regarding the predictors of mortality after successful weaning of venoarterial extracorporeal membrane oxygenation (ECMO). We aimed to identify predictors of in-hospital mortality in patients with cardiogenic shock (CS) after successful weaning from ECMO. Data were obtained from a multicenter registry of CS. Successful ECMO weaning was defined as survival with minimal mean arterial pressure (> 65 mmHg) for > 24 h after ECMO removal. The primary outcome was in-hospital mortality after successful ECMO weaning. Among 1247 patients with CS, 485 received ECMO, and 262 were successfully weaned from ECMO. In-hospital mortality occurred in 48 patients (18.3%). Survivors at discharge differed significantly from non-survivors in age, cardiovascular comorbidities, cause of CS, left ventricular ejection fraction, and use of adjunctive therapy. Five independent predictors for in-hospital mortality were identified: use of continuous renal replacement therapy (odds ratio 5.429, 95% confidence interval [CI] 2.468–11.940; p < 0.001), use of intra-aortic balloon pump (3.204, 1.105–9.287; p = 0.032), diabetes mellitus (3.152, 1.414–7.023; p = 0.005), age (1.050, 1.016–1.084; p = 0.003), and left ventricular ejection fraction after ECMO insertion (0.957, 0.927–0.987; p = 0.006). Even after successful weaning of ECMO, patients with irreversible risk factors should be recognized, and careful monitoring should be done for sign of deconditioning.
- Subjects
INTRA-aortic balloon counterpulsation; EXTRACORPOREAL membrane oxygenation; CARDIOGENIC shock; HOSPITAL mortality; VENTRICULAR ejection fraction; DISEASE risk factors
- Publication
Scientific Reports, 2023, Vol 13, Issue 1, p1
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-023-44679-2