Postcardiotomy extracorporeal membrane oxygenation in patients older than 70 years: Characteristics, outcomes, and variables associated with mortality

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F25%3A10500005" target="_blank" >RIV/00064165:_____/25:10500005 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11110/25:10500005

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=hBZS4.99_U" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=hBZS4.99_U</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.xjon.2025.04.004" target="_blank" >10.1016/j.xjon.2025.04.004</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Postcardiotomy extracorporeal membrane oxygenation in patients older than 70 years: Characteristics, outcomes, and variables associated with mortality

Popis výsledku v původním jazyce

Objectives: Age is the main determinant for mortality in patients requiring postcardiotomy extracorporeal membrane oxygenation (PC-ECMO), but strategies to reverse this trend are unknown. This study investigates PC-ECMO outcomes in older patients (&gt;= 70 years) compared with younger patients (&lt;70 years). Methods: This retrospective study included patients who required PC-ECMO between 2000 and 2020. Variables independently associated with in-hospital mortality were identified using mixed Cox proportional hazards models. Results: The study included 2057 patients (mean age: 62.3 [first and third quartile: 19-94]; male patients: n =1213 [59%]): 1376 (67%) were&lt;70 years and 680 (33%) were &gt;= 70 years old. Older patients had more preoperative comorbidities, whereas younger patients had lower cardiac function and more preoperative intubation and vasopressor use. In-hospital mortality was 56.3% (n =775) and 68.8% (n = 468) in the &lt;70 year and &gt;= 70 year groups, respectively (P &lt; .001). The 7-year postdischarge survival rate was greater for the younger patient group (P &lt; .001). Variables associated with in-hospital mortality in older patients were previous stroke (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.05-1.84), preoperative right ventricular failure (HR, 1.45; 95% CI, 1-2.1), aortic surgery (HR 1.65; 95% CI, 1.2-2.2), and postoperative complications including bleeding (HR 1.24; 95% CI, 1.0-1.5), cardiac arrest (HR, 1.65; 95% CI, 1.3-2.1), and right ventricular failure (HR, 1.29; 95% CI, 1.0-1.6). Conclusions: PC-ECMO mortality is high in older patients. Preoperative factors including previous stroke and right ventricular failure and postoperative factors including bleeding, cardiac arrest, and right ventricular failure should be targeted to reduce in-hospital mortality after appropriate initial selection in older patients.

Název v anglickém jazyce

Postcardiotomy extracorporeal membrane oxygenation in patients older than 70 years: Characteristics, outcomes, and variables associated with mortality

Popis výsledku anglicky

Objectives: Age is the main determinant for mortality in patients requiring postcardiotomy extracorporeal membrane oxygenation (PC-ECMO), but strategies to reverse this trend are unknown. This study investigates PC-ECMO outcomes in older patients (&gt;= 70 years) compared with younger patients (&lt;70 years). Methods: This retrospective study included patients who required PC-ECMO between 2000 and 2020. Variables independently associated with in-hospital mortality were identified using mixed Cox proportional hazards models. Results: The study included 2057 patients (mean age: 62.3 [first and third quartile: 19-94]; male patients: n =1213 [59%]): 1376 (67%) were&lt;70 years and 680 (33%) were &gt;= 70 years old. Older patients had more preoperative comorbidities, whereas younger patients had lower cardiac function and more preoperative intubation and vasopressor use. In-hospital mortality was 56.3% (n =775) and 68.8% (n = 468) in the &lt;70 year and &gt;= 70 year groups, respectively (P &lt; .001). The 7-year postdischarge survival rate was greater for the younger patient group (P &lt; .001). Variables associated with in-hospital mortality in older patients were previous stroke (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.05-1.84), preoperative right ventricular failure (HR, 1.45; 95% CI, 1-2.1), aortic surgery (HR 1.65; 95% CI, 1.2-2.2), and postoperative complications including bleeding (HR 1.24; 95% CI, 1.0-1.5), cardiac arrest (HR, 1.65; 95% CI, 1.3-2.1), and right ventricular failure (HR, 1.29; 95% CI, 1.0-1.6). Conclusions: PC-ECMO mortality is high in older patients. Preoperative factors including previous stroke and right ventricular failure and postoperative factors including bleeding, cardiac arrest, and right ventricular failure should be targeted to reduce in-hospital mortality after appropriate initial selection in older patients.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

JTCVS open

ISSN

2666-2736

e-ISSN

2666-2736

Svazek periodika

25

Číslo periodika v rámci svazku

June

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

10

Strana od-do

163-172

Kód UT WoS článku

001519292400011

EID výsledku v databázi Scopus

2-s2.0-105004271609