Affiliation:
1. College of Medicine, University of Arizona Sarver Heart Center, 1501 North Campbell Avenue, Tucson, AZ 85724, USA
2. College of Medicine, University of Arizona, Phoenix, AZ 85004, USA
Abstract
Background: The goal of this study was to evaluate the effect of extracorporeal membrane oxygenation (ECMO) on mortality in patients with cardiogenic shock excluding Impella and IABP use. Method: The large Nationwide Inpatient Sample (NIS) database was utilized to study any association between the use of ECMO in adults over the age of 18 and mortality and complications with a diagnosis of cardiogenic shocks. Results: ICD-10 codes for ECMO and cardiogenic shock for the available years 2016–2020 were utilized. A total of 796,585 (age 66.5 ± 14.4) patients had a diagnosis of cardiogenic shock excluding Impella. Of these patients, 13,160 (age 53.7 ± 15.4) were treated with ECMO without IABP use. Total inpatient mortality without any device was 32.7%. It was 47.9% with ECMO. In a multivariate analysis adjusting for 47 variables such as age, gender, race, lactic acidosis, three-vessel intervention, left main myocardial infarction, cardiomyopathy, systolic heart failure, acute ST-elevation myocardial infarction, peripheral vascular disease, chronic renal disease, etc., ECMO utilization remained highly associated with mortality (OR: 1.78, CI: 1.6–1.9, p < 0.001). Evaluating teaching hospitals only revealed similar findings. Major complications were also high in the ECMO cohort. Conclusions: In patients with cardiogenic shock, the use of ECMO was associated with the high in-hospital mortality regardless of comorbid condition, high-risk futures, or type of hospital.
Reference38 articles.
1. Temporal trends in cardiogenic shock complicating acute myocardial infarction;Goldberg;N. Engl. J. Med.,1999
2. Thirty-year trends (1975 to 2005) in the magnitude of, management of, and hospital death rates associated with cardiogenic shock in patients with acute myocardial infarction: A population-based perspective;Goldberg;Circulation,2009
3. Cardiogenic Shock;Vahdatpour;J. Am. Heart Assoc.,2019
4. Acute Mechanical Circulatory Support for Cardiogenic Shock;Telukuntla;Methodist. Debakey Cardiovasc. J.,2020
5. National Trends for Temporary Mechanical Circulatory Support Utilization in Patients with Cardiogenic Shock from Decompensated Chronic Heart Failure: Incidence, Predictors, Outcomes, and Cost;Malik;J. Soc. Cardiovasc. Angiogr. Interv.,2023