Characteristics and outcomes of patients with COVID-19 supported by extracorporeal membrane oxygenation: A retrospective multicenter study.
Characteristics and outcomes of patients with COVID-19 supported by extracorporeal membrane oxygenation: A retrospective multicenter study.
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DOI：
10.1016/j.jtcvs.2021.04.089
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发表时间：
2022-06
期刊：
影响因子：
--
通讯作者：
COVID-19 ECMO Working Group
中科院分区：
文献类型：
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作者：
Saeed O;Tatooles AJ;Farooq M;Schwartz G;Pham DT;Mustafa AK;D'Alessandro D;Abrol S;Jorde UP;Gregoric ID;Radovancevic R;Lima B;Bryner BS;Ravichandran A;Salerno CT;Spencer P;Friedmann P;Silvestry S;Goldstein DJ;COVID-19 ECMO Working Group
确定需要体外膜肺氧合 (ECMO) 支持的 COVID-19 患者的特征、结果和与死亡相关的临床因素。进行了一项多中心、回顾性队列研究。该队列由 2020 年 3 月 1 日至 2020 年 9 月 30 日期间需要 ECMO 的成年患者（18 岁及以上）组成。主要结局是 ECMO 启动后的院内死亡率，并通过 90 天的事件发生时间分析进行评估。多变量 Cox 比例回归用于确定与院内死亡率相关的因素。总体而言，研究队列中有来自 17 个中心的 292 名患者。患者年龄为 49 岁（四分位距，39-57），其中 81 名（28%）为女性。随访期结束时，19例（6%）患者仍在接受ECMO，25例（9%）停止ECMO但仍住院，135例（46%）出院或活着转院，113例（39%）在住院期间死亡。 90 天的累积院内死亡率为 42%（95% 置信区间 [CI]，36%-47%）。与院内死亡率相关的因素包括年龄（调整后风险比 [aHR]，1.31；95% CI，每 10 年 1.06-1.61）、根据血清肌酐水平测量的肾功能障碍（aHR，1.21；95% CI，1.01-1.45）以及 ECMO 放置前的心肺复苏（aHR，1.87；95% CI，1.01-1.45）。 95% CI，1.01-3.46）。在需要 ECMO 支持的重症 COVID-19 患者中，不到一半的病例发生院内死亡。 ECMO 可能是治疗难治性 COVID-19 绝症患者的一种可行方式。这是一项多中心、回顾性队列研究，研究对象为 2020 年 3 月 1 日至 2020 年 9 月 30 日期间在美国 17 个中心接受体外膜肺氧合 (ECMO) 的 292 名 COVID-19 患者。临床特征和结果已输入研究电子数据捕获 (REDCap) 数据库。 90 天累积院内死亡率的主要结局为 42%（95% 置信区间 [CI]，36%-47%）。
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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DOI：
10.1016/j.jiac.2020.10.019
发表时间：
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期刊：
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影响因子：
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