Author + information
- Suzanne de Waha,
- Steffen Desch,
- Tobias Graf,
- Georg Fuernau,
- Ingo Eitel,
- Janine Poess,
- Thomas Stiermaier,
- Alexander Jobs,
- Jakob Ledwoch,
- Philipp Lurz,
- Gerhard Schuler and
- Holger Thiele
Background: The current study presents data from a real-world cohort of patients with refractory cardiogenic shock (CS) undergoing extracorporeal life support (ECLS) with the aim to report clinical experience and objectify complications as well as survival focusing on the comparison of elderly versus younger patients.
Methods: One hundred consecutive patients with refractory CS underwent percutaneous ECLS implantation performed by interventional cardiologists. Follow-up was performed at hospital discharge as well as at a median of 18 months (interquartile range [IQR] 15-36). Patients were grouped according to median age (≤60 years versus >60 years).
Results: The rate of local as well as systemic complications was high and did not differ between patients ≤60 years in comparison to those >60 years (e.g. access site complications including bleeding, ischemia or infection: 32% versus 36%, p=0.83). ECLS could be weaned in more than half of the cohort (56%) with no differences between the age groups (p=1.00). Despite similar rates of initial hemodynamic stabilization, in-hospital mortality was higher in patients >60 years (82% versus 58%, p=0.02). At long-term follow-up, only 6% of patients were alive in the group of patients >60 years. This resulted in a mortality rate of 94% in the elderly in comparison to 68% in patients aged ≤60 years (p=0.001).
Conclusions: Despite a high rate of initial successful ECLS weaning, long-term prognosis of patients with CS undergoing ECLS above the age of 60 years is poor with superior results in patients aged ≤60 years. Thus, patients at higher age appear to have a lower potential to permanently recover following ECLS explantation. This might be explained by poor organ reserve and a lower intrinsic capability of functional improvement as well as a higher susceptibility to serious complications associated with ECLS.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Developments in Acute Coronary Syndromes
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1194-147
- 2017 American College of Cardiology Foundation