Outcomes of Venoarterial Extracorporeal Membrane Oxygenation for Cardiac Arrest in Adult Patients in the United States

Author:

Gill George1ORCID,Patel Jignesh K.2,Casali Diego1,Rowe Georgina1,Meng Hongdao3,Megna Dominick1,Chikwe Joanna1,Parikh Puja B.4

Affiliation:

1. Department of Cardiac Surgery, Smidt Heart Institute Cedars‐Sinai Medical Center Los Angeles CA

2. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine Stony Brook University Medical Center Stony Brook NY

3. School of Aging Studies University of South Florida Tampa FL

4. Division of Cardiology, Department of Medicine Stony Brook University Medical Center Stony Brook NY

Abstract

Background Factors associated with poor prognosis following receipt of extracorporeal membrane oxygenation (ECMO) in adults with cardiac arrest remain unclear. We aimed to identify predictors of mortality in adults with cardiac arrest receiving ECMO in a nationally representative sample. Methods and Results The US Healthcare Cost and Utilization Project's National Inpatient Sample was used to identify 782 adults hospitalized with cardiac arrest who received ECMO between 2006 and 2014. The primary outcome of interest was all‐cause in‐hospital mortality. Factors associated with mortality were analyzed using multivariable logistic regression. The overall in‐hospital mortality rate was 60.4% (n=472). Patients who died were older and more often men, of non‐White race, and with lower household income than those surviving to discharge. In the risk‐adjusted analysis, independent predictors of mortality included older age, male sex, lower annual income, absence of ventricular arrhythmia, absence of percutaneous coronary intervention, and presence of therapeutic hypothermia. Conclusions Demographic and therapeutic factors are independently associated with mortality in patients with cardiac arrest receiving ECMO. Identification of which patients with cardiac arrest may receive the utmost benefit from ECMO may aid with decision‐making regarding its implementation. Larger‐scale studies are warranted to assess the appropriate candidates for ECMO in cardiac arrest.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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