Author + information
- Sakir Akin,
- Kadir Caliskan,
- Osama Soliman,
- L.S.D. Jewbali,
- Corstiaan den Uil,
- Atila Kara,
- Alina Constantinescu,
- Robert J. van Thiel,
- Ron van Domburg,
- Jan Bakker and
- Dinis dos Reis Miranda
Background: High mortality remains a major complication of an increasingly used veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock. The Sequential Organ Failure Assessment (SOFA) score is known to predict ICU mortality.
Methods: Multivariate logistic regression analysis was performed to investigate predictors of ICU mortality in all patients on VA-ECMO between 2004 and 2015 in our tertiary referral hospital. Variables included SOFA score, age, C-reactive protein (CRP), heart failure etiology, and persisting right heart failure (RHF) during VA-ECMO on echocardiography.
Results: The study comprised of 103 patients with a mean age of 49±16 years, 54% male. Causes of cardiogenic shock were: ischemic in 23 (22%), non-ischemic in 25 (24%), postcardiotomy in 25 (24%) and 30 (29%) of various etiology. During a median VA-ECMO support of 7 days [rage 0-52], 63 (61%) survived ICU, with 10 patients bridged to left ventricular assist device, 2 to heart transplant. Twenty-two (21%) patients had a persisting RV failure during VA-ECMO support with 86% mortality. A combined SOFA and a severe persisting RHF score has 4 fold (OR =27.2, 95% CI 6.5- 113.6) vs. (OR=7.1, 95% CI 2.2-23.3) more predictive value of ICU mortality compared with SOFA score alone.
Conclusions: Adding RHF to SOFA score better predicts ICU mortality in patients supported by VA-ECMO.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 10:45 a.m.-10:55 a.m.
Session Title: Why Can't We Be Friends? Controversies in Heart Failure Management
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1137M-09
- 2017 American College of Cardiology Foundation