A Simple Scoring System to Predict Survival after Venoarterial Extracorporeal Membrane Oxygenation.

A Simple Scoring System to Predict Survival after Venoarterial Extracorporeal Membrane Oxygenation. J Extra Corpor Technol. 2019 Sep;51(3):133-139 Authors: Worku B, Khin S, Gaudino M, Avgerinos D, Gambardella I, D'Ayala M, Ramasubbu K, Gulkarov I, Salemi A Abstract Patients undergoing consideration for venoarterial extracorporeal membrane oxygenation (VA ECMO) require an immediate risk profile assessment in the setting of incomplete or no information. A retrospective cohort study of 100 patients undergoing VA ECMO placement at three institutions was carried out. Variables strongly associated with survival to discharge were used to calculate a risk stratification score. Indications for VA ECMO support included postcardiotomy shock (24%), ischemic etiologies (33%), nonischemic cardiomyopathy (32%), and other etiologies (11%). Pre-VA ECMO arrest occurred in 69%, and 30% of patients underwent cannulation during arrest. Survival to discharge was 38%. Three variables demonstrated a strong trend toward predicting survival to discharge: lactate >10 mmol/L (p = .054), albumin <3 g/dL (p = .062), and platelet count <180 K/uL (p = .064), and these variables were included in a scoring system. The extremes of age and duration of pre-VA ECMO ventilation were associated with a dismal prognosis and were also included. These five variables were used to construct a mortality prediction score. A score of 0 was associated with 10% expected mort...
Source: Journal of Extra-Corporeal Technology - Category: Cardiovascular & Thoracic Surgery Tags: J Extra Corpor Technol Source Type: research