Age is major factor for predicting survival in patients with acute respiratory failure on extracorporeal membrane oxygenation: a Korean multicenter study
Age is major factor for predicting survival in patients with acute respiratory failure on extracorporeal membrane oxygenation: a Korean multicenter study
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DOI：
10.21037/jtd.2018.03.71
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发表时间：
2018-03-01
影响因子：
2.5
通讯作者：
Hong, Sang-Bum
中科院分区：
文献类型：
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作者：
Baek, Moon Seong;Chung, Chi Ryang;Hong, Sang-Bum
背景：重症监护室中老年患者的比例正在增加。尽管呼吸体外膜氧合生存预测（RESP）评分广泛用于体外膜氧合（ECMO）患者的生存预测，但RESP评分是否适用于老年患者仍存在疑问。本研究的目的是调查RESP评分在韩国coherent.Methods的适用性：数据回顾性分析2014年至2015年在11家医院接受ECMO治疗的209例急性呼吸衰竭（ARF）患者。结果预测模型进行比较和多变量Logistic回归分析，以确定独立的危险因素，医院mortality.Results：在所有患者中，中位年龄为58（IQR，45-65）岁。出院时的总生存率为45.9%，82.3%的患者使用了静脉-静脉ECMO。年龄大于65岁的患者接受ECMO支持治疗51例，住院生存率为31.4%。VV-ECMO（PRESERVE）和RESP评分对重度ARDS的预测值可显著预测患者的死亡率，曲线下面积（AUC）分别为0.63 [95%置信区间（CI），0.54-0.72]和0.66（95% CI，0.58-0.73）。多因素Logistic回归分析显示，年龄是住院死亡的独立危险因素[OR 1.044（95%CI，1.020-1.068），P
Background: The proportion of elderly patients in the intensive care unit population is increasing. Although the Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) score is widely used for survival prediction of extracorporeal membrane oxygenation (ECMO) patients, it is questionable whether the RESP score is applicable to older patients. The aim of this study was to investigate the applicability of the RESP score in Korean cohort.Methods: Data were retrospectively analyzed from 209 acute respiratory failure (ARF) patients treated with ECMO from 2014 to 2015 at 11 hospitals. A comparison of outcome prediction models was conducted and multivariate logistic regression analysis was performed to identify independent risk factors for hospital mortality.Results: In all patients, the median age was 58 (IQR, 45-65) years. Overall survival at hospital discharge was 45.9%, and veno-venous ECMO was used in 82.3% of patients. Patients older than 65 years treated with ECMO support were 51 with 31.4% of hospital survival. The PRedicting dEath for SEvere ARDS on VV-ECMO (PRESERVE) and RESP scores significantly predicted mortality in patients, with areas under the curve (AUCs) of 0.63 [95% confidence interval (CI), 0.54-0.72] and 0.66 (95% CI, 0.58-0.73), respectively. In multivariate logistic regression analysis, age is independent risk factor for hospital mortality [odds ratio 1.044 (95% CI, 1.020-1.068), P