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Survival following venoarterial extracorporeal membrane oxygenation in postcardiotomy cardiogenic shock adults.

Authors
  • Chen, Fei1
  • Wang, Liangshan1
  • Shao, Juanjuan1
  • Wang, Hong1
  • Hou, Xiaotong1
  • Jia, Ming1
  • 1 Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China. , (China)
Type
Published Article
Journal
Perfusion
Publisher
SAGE Publications
Publication Date
Nov 01, 2020
Volume
35
Issue
8
Pages
747–755
Identifiers
DOI: 10.1177/0267659120931306
PMID: 32529901
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Studies reporting long-term outcomes of venoarterial extracorporeal membrane oxygenation-treated coronary artery bypass grafting patients are scarce. The objective of this study was to examine the survival outcomes and identify mortality risk factors for coronary artery bypass grafting patients who received venoarterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock. Data from 121 consecutive venoarterial extracorporeal membrane oxygenation-treated coronary artery bypass grafting patients at the Beijing Anzhen Hospital between January 2012 and December 2016 were analyzed. Multivariable Cox regression modeling was used to identify factors independently associated with 36-month mortality. Seventy-seven patients (64%) could be weaned from venoarterial extracorporeal membrane oxygenation, 56 patients (46%) survived to hospital discharge, and 41 patients (34%) survived to 36 months. Older age (hazard ratio, 1.06; 95% confidence interval [CI], 1.03-1.10; p < 0.001), left main coronary artery disease (hazard ratio, 1.64; 95% CI, 1.04-2.59; p < 0.001), and vasoactive inotropic score (hazard ratio, 1.09; 95% CI, 1.02-1.16; p = 0.011) were independent risk factors associated with 36-month mortality. The area under the receiver operating characteristic curve for the logistic regression model, which was constructed with three pre-extracorporeal membrane oxygenation parameters-age ⩾ 60 years, left main coronary artery disease, and vasoactive inotropic score > 60-was 0.87 (95% CI, 0.81-0.94). Age and left main coronary artery disease significantly increased the discriminatory performance of Sepsis-related Organ Failure Assessment score (0.79 vs. 0.91, p = 0.025). Older age, left main coronary artery disease, and vasoactive inotropic score were associated with 36-month mortality in coronary artery bypass grafting patients who received venoarterial extracorporeal membrane oxygenation.

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