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. 2024 Dec;46(2):2395450.
doi: 10.1080/0886022X.2024.2395450. Epub 2024 Aug 30.

Risk factors for mortality in patients receiving extracorporeal membrane oxygenation

Junjie Wang  1 , Suiqing Huang  1 , Kangni Feng  1 , Huawei Wu  2 , Liqun Shang  1 , Zhuoming Zhou  1 , Quan Liu  1 , Jiantao Chen  1 , Mengya Liang  1 , Guangxian Chen  1   3 , Jian Hou  4 , Zhongkai Wu  1
Affiliations

Risk factors for mortality in patients receiving extracorporeal membrane oxygenation

Junjie Wang et al. Ren Fail. 2024 Dec.

Abstract

Objective: Patients on extracorporeal membrane oxygenation (ECMO) are often complex and have a high mortality rate. Currently, risk assessment and treatment decisions for patients receiving ECMO are controversial. Therefore, we sought to identify risk factors for mortality in patients receiving ECMO and provide a reference for patient management.

Methods: We retrospectively analyzed the clinical data of 199 patients who received ECMO support from December 2013 to April 2023. Univariate and multivariable logistic regression analyses were used to identify risk factors. The cutoff value was determined by receiver operating characteristic (ROC) curve analysis.

Results: A total of 199 patients were selected for this study, and the mortality rate was 76.38%. More than half of the patients underwent surgery during hospitalization. Multivariable logistic regression analysis revealed that continuous renal replacement therapy (CRRT) implantation (OR = 2.994; 95% CI, 1.405-6.167; p = 0.004) and age (OR = 1.021; 95% CI, 1.002-1.040; p = 0.032) were the independent risk factors for mortality. In the ROC curve analysis, age had the best predictive effect (AUC 0.646, 95% CI 0.559-0.732, p = 0.003) for death when the cutoff value was 48.5 years. Furthermore, in patients receiving combined CRRT and ECMO, lack of congenital heart disease and previous surgical history were the independent risk factors for mortality.

Conclusions: CRRT implantation and age were independent risk factors for patients with ECMO implantation in a predominantly surgical cohort. In patients receiving a combination of CRRT and ECMO, lack of congenital heart disease and previous surgical history were independent risk factors for mortality.

Keywords: Extracorporeal membrane oxygenation; acute renal injury; continuous renal replacement therapy; mortality; risk factors.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Flowchart for inclusion and exclusion of patients with ECMO implantation. ECMO: extracorporeal membrane oxygenation; CRRT: continuous renal replacement therapy.
Figure 2.
Figure 2.
ROC curve analysis of age for predicting death in patients undergoing ECMO implantation. ROC: receiver operating characteristic; ECMO: extracorporeal membrane oxygenation.
See this image and copyright information in PMC

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References

    1. Mosier JM, Kelsey M, Raz Y, et al. . Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions. Crit Care. 2015;19(1):431. doi: 10.1186/s13054-015-1155-7. - DOI - PMC - PubMed
    1. Combes A, Peek GJ, Hajage D, et al. . ECMO for severe ARDS: systematic review and individual patient data meta-analysis. Intensive Care Med. 2020;46(11):2048–2057. doi: 10.1007/s00134-020-06248-3. - DOI - PMC - PubMed
    1. Deatrick KB, Mazzeffi MA, Galvagno SM, et al. . Breathing life back into the kidney—continuous renal replacement therapy and veno-venous extracorporeal membrane oxygenation. ASAIO J. 2021;67(2):208–212. doi: 10.1097/MAT.0000000000001210. - DOI - PubMed
    1. Gao S, Liu G, Yan S, et al. . Outcomes from adult veno-arterial extracorporeal membrane oxygenation in a cardiovascular disease center from 2009 to 2019. Perfusion. 2022;37(3):235–241. doi: 10.1177/0267659121993365. - DOI - PubMed
    1. Rozencwajg S, Pilcher D, Combes A, et al. . Outcomes and survival prediction models for severe adult acute respiratory distress syndrome treated with extracorporeal membrane oxygenation. Crit Care. 2016;20(1):392. doi: 10.1186/s13054-016-1568-y. - DOI - PMC - PubMed

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