Characteristics and outcomes of patients with COVID-19 supported by extracorporeal membrane oxygenation: A retrospective multicenter study
To determine characteristics, outcomes, and clinical factors associated with death in patients with COVID-19 requiring extracorporeal membrane oxygenation (ECMO) support. A multicenter, retrospective cohort study was conducted. The cohort consisted of adult patients (18 years of age and older) requi...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2022-06, Vol.163 (6), p.2107-2116.e6 |
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| creator | Saeed, Omar Tatooles, Antone J. Farooq, Muhammad Schwartz, Gary Pham, Duc T. Mustafa, Asif K. D'Alessandro, David Abrol, Sunil Jorde, Ulrich P. Gregoric, Igor D. Radovancevic, Rajko Lima, Brian Bryner, Benjamin S. Ravichandran, Ashwin Salerno, Christopher T. Spencer, Philip Friedmann, Patricia Silvestry, Scott Goldstein, Daniel J. Alvarez, Chikezie DeAnda, Abe Gluck, Jason Jermyn, Rita Kuntzman, Matthew McKellar, Stephen Parides, Michael K. Saunders, Paul |
| description | To determine characteristics, outcomes, and clinical factors associated with death in patients with COVID-19 requiring extracorporeal membrane oxygenation (ECMO) support.
A multicenter, retrospective cohort study was conducted. The cohort consisted of adult patients (18 years of age and older) requiring ECMO in the period from March 1, 2020, to September 30, 2020. The primary outcome was in-hospital mortality after ECMO initiation assessed with a time to event analysis at 90 days. Multivariable Cox proportional regression was used to determine factors associated with in-hospital mortality.
Overall, 292 patients from 17 centers comprised the study cohort. Patients were 49 (interquartile range, 39-57) years old and 81 (28%) were female. At the end of the follow-up period, 19 (6%) patients were still receiving ECMO, 25 (9%) were discontinued from ECMO but remained hospitalized, 135 (46%) were discharged or transferred alive, and 113 (39%) died during the hospitalization. The cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). Factors associated with in-hospital mortality were age (adjusted hazard ratio [aHR], 1.31; 95% CI, 1.06-1.61 per 10 years), renal dysfunction measured according to serum creatinine level (aHR, 1.21; 95% CI, 1.01-1.45), and cardiopulmonary resuscitation before ECMO placement (aHR, 1.87; 95% CI, 1.01-3.46).
In patients with severe COVID-19 necessitating ECMO support, in-hospital mortality occurred in fewer than half of the cases. ECMO might serve as a viable modality for terminally ill patients with refractory COVID-19.
A multicenter, retrospective cohort study of 292 patients with COVID-19 given extracorporeal membrane oxygenation (ECMO) in 17 centers across the United States from March 1, 2020 to September 30, 2020. Clinical characteristics and outcomes were entered into a Research Electronic Data Capture (REDCap) database. The primary outcome of cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). [Display omitted] |
| doi_str_mv | 10.1016/j.jtcvs.2021.04.089 |
| format | Article |
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A multicenter, retrospective cohort study was conducted. The cohort consisted of adult patients (18 years of age and older) requiring ECMO in the period from March 1, 2020, to September 30, 2020. The primary outcome was in-hospital mortality after ECMO initiation assessed with a time to event analysis at 90 days. Multivariable Cox proportional regression was used to determine factors associated with in-hospital mortality.
Overall, 292 patients from 17 centers comprised the study cohort. Patients were 49 (interquartile range, 39-57) years old and 81 (28%) were female. At the end of the follow-up period, 19 (6%) patients were still receiving ECMO, 25 (9%) were discontinued from ECMO but remained hospitalized, 135 (46%) were discharged or transferred alive, and 113 (39%) died during the hospitalization. The cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). Factors associated with in-hospital mortality were age (adjusted hazard ratio [aHR], 1.31; 95% CI, 1.06-1.61 per 10 years), renal dysfunction measured according to serum creatinine level (aHR, 1.21; 95% CI, 1.01-1.45), and cardiopulmonary resuscitation before ECMO placement (aHR, 1.87; 95% CI, 1.01-3.46).
In patients with severe COVID-19 necessitating ECMO support, in-hospital mortality occurred in fewer than half of the cases. ECMO might serve as a viable modality for terminally ill patients with refractory COVID-19.
A multicenter, retrospective cohort study of 292 patients with COVID-19 given extracorporeal membrane oxygenation (ECMO) in 17 centers across the United States from March 1, 2020 to September 30, 2020. Clinical characteristics and outcomes were entered into a Research Electronic Data Capture (REDCap) database. The primary outcome of cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). [Display omitted]</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2021.04.089</identifier><identifier>PMID: 34112505</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Adult: Mechanical Circulatory Support ; ARDS ; Child ; COVID-19 ; COVID-19 - therapy ; ECMO ; Extracorporeal Membrane Oxygenation - adverse effects ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; mortality ; Respiratory Distress Syndrome ; Retrospective Studies</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2022-06, Vol.163 (6), p.2107-2116.e6</ispartof><rights>2021 The American Association for Thoracic Surgery</rights><rights>Copyright © 2021 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><rights>2021 by The American Association for Thoracic Surgery. 2021 The American Association for Thoracic Surgery</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c409t-38b1b65a5aa3e430960959ef00ae2014a779999ecbb2525599d57854419aea423</cites><orcidid>0000-0001-6432-0730</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522321008011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34112505$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Saeed, Omar</creatorcontrib><creatorcontrib>Tatooles, Antone J.</creatorcontrib><creatorcontrib>Farooq, Muhammad</creatorcontrib><creatorcontrib>Schwartz, Gary</creatorcontrib><creatorcontrib>Pham, Duc T.</creatorcontrib><creatorcontrib>Mustafa, Asif K.</creatorcontrib><creatorcontrib>D'Alessandro, David</creatorcontrib><creatorcontrib>Abrol, Sunil</creatorcontrib><creatorcontrib>Jorde, Ulrich P.</creatorcontrib><creatorcontrib>Gregoric, Igor D.</creatorcontrib><creatorcontrib>Radovancevic, Rajko</creatorcontrib><creatorcontrib>Lima, Brian</creatorcontrib><creatorcontrib>Bryner, Benjamin S.</creatorcontrib><creatorcontrib>Ravichandran, Ashwin</creatorcontrib><creatorcontrib>Salerno, Christopher T.</creatorcontrib><creatorcontrib>Spencer, Philip</creatorcontrib><creatorcontrib>Friedmann, Patricia</creatorcontrib><creatorcontrib>Silvestry, Scott</creatorcontrib><creatorcontrib>Goldstein, Daniel J.</creatorcontrib><creatorcontrib>Alvarez, Chikezie</creatorcontrib><creatorcontrib>DeAnda, Abe</creatorcontrib><creatorcontrib>Gluck, Jason</creatorcontrib><creatorcontrib>Jermyn, Rita</creatorcontrib><creatorcontrib>Kuntzman, Matthew</creatorcontrib><creatorcontrib>McKellar, Stephen</creatorcontrib><creatorcontrib>Parides, Michael K.</creatorcontrib><creatorcontrib>Saunders, Paul</creatorcontrib><creatorcontrib>COVID-19 ECMO Working Group</creatorcontrib><title>Characteristics and outcomes of patients with COVID-19 supported by extracorporeal membrane oxygenation: A retrospective multicenter study</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>To determine characteristics, outcomes, and clinical factors associated with death in patients with COVID-19 requiring extracorporeal membrane oxygenation (ECMO) support.
A multicenter, retrospective cohort study was conducted. The cohort consisted of adult patients (18 years of age and older) requiring ECMO in the period from March 1, 2020, to September 30, 2020. The primary outcome was in-hospital mortality after ECMO initiation assessed with a time to event analysis at 90 days. Multivariable Cox proportional regression was used to determine factors associated with in-hospital mortality.
Overall, 292 patients from 17 centers comprised the study cohort. Patients were 49 (interquartile range, 39-57) years old and 81 (28%) were female. At the end of the follow-up period, 19 (6%) patients were still receiving ECMO, 25 (9%) were discontinued from ECMO but remained hospitalized, 135 (46%) were discharged or transferred alive, and 113 (39%) died during the hospitalization. The cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). Factors associated with in-hospital mortality were age (adjusted hazard ratio [aHR], 1.31; 95% CI, 1.06-1.61 per 10 years), renal dysfunction measured according to serum creatinine level (aHR, 1.21; 95% CI, 1.01-1.45), and cardiopulmonary resuscitation before ECMO placement (aHR, 1.87; 95% CI, 1.01-3.46).
In patients with severe COVID-19 necessitating ECMO support, in-hospital mortality occurred in fewer than half of the cases. ECMO might serve as a viable modality for terminally ill patients with refractory COVID-19.
A multicenter, retrospective cohort study of 292 patients with COVID-19 given extracorporeal membrane oxygenation (ECMO) in 17 centers across the United States from March 1, 2020 to September 30, 2020. Clinical characteristics and outcomes were entered into a Research Electronic Data Capture (REDCap) database. The primary outcome of cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). 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A multicenter, retrospective cohort study was conducted. The cohort consisted of adult patients (18 years of age and older) requiring ECMO in the period from March 1, 2020, to September 30, 2020. The primary outcome was in-hospital mortality after ECMO initiation assessed with a time to event analysis at 90 days. Multivariable Cox proportional regression was used to determine factors associated with in-hospital mortality.
Overall, 292 patients from 17 centers comprised the study cohort. Patients were 49 (interquartile range, 39-57) years old and 81 (28%) were female. At the end of the follow-up period, 19 (6%) patients were still receiving ECMO, 25 (9%) were discontinued from ECMO but remained hospitalized, 135 (46%) were discharged or transferred alive, and 113 (39%) died during the hospitalization. The cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). Factors associated with in-hospital mortality were age (adjusted hazard ratio [aHR], 1.31; 95% CI, 1.06-1.61 per 10 years), renal dysfunction measured according to serum creatinine level (aHR, 1.21; 95% CI, 1.01-1.45), and cardiopulmonary resuscitation before ECMO placement (aHR, 1.87; 95% CI, 1.01-3.46).
In patients with severe COVID-19 necessitating ECMO support, in-hospital mortality occurred in fewer than half of the cases. ECMO might serve as a viable modality for terminally ill patients with refractory COVID-19.
A multicenter, retrospective cohort study of 292 patients with COVID-19 given extracorporeal membrane oxygenation (ECMO) in 17 centers across the United States from March 1, 2020 to September 30, 2020. Clinical characteristics and outcomes were entered into a Research Electronic Data Capture (REDCap) database. The primary outcome of cumulative in-hospital mortality at 90 days was 42% (95% confidence interval [CI], 36%-47%). [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34112505</pmid><doi>10.1016/j.jtcvs.2021.04.089</doi><orcidid>https://orcid.org/0000-0001-6432-0730</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0022-5223 |
| ispartof | The Journal of thoracic and cardiovascular surgery, 2022-06, Vol.163 (6), p.2107-2116.e6 |
| issn | 0022-5223 1097-685X |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adult Adult: Mechanical Circulatory Support ARDS Child COVID-19 COVID-19 - therapy ECMO Extracorporeal Membrane Oxygenation - adverse effects Female Hospital Mortality Humans Male Middle Aged mortality Respiratory Distress Syndrome Retrospective Studies |
| title | Characteristics and outcomes of patients with COVID-19 supported by extracorporeal membrane oxygenation: A retrospective multicenter study |
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