Risk factor screening scale to optimize treatment for potential heart transplant candidates under extracorporeal membrane oxygenation
Risk factor screening scale to optimize treatment for potential heart transplant candidates under extracorporeal membrane oxygenation
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DOI：
10.1111/j.1600-6143.2004.00578.x
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发表时间：
2004-11-01
影响因子：
8.8
通讯作者：
Yu, HY
中科院分区：
文献类型：
--
作者：
Chen, YS;Ko, WJ;Yu, HY
我们制定了危险因素评分（RFSS），以选择哪些接受体外膜肺氧合（ECMO）支持的患者适合心室辅助装置（VAD）植入或心脏移植（HTx）。本研究共纳入 78 例因心源性原因接受 ECMO 治疗超过 48 小时的患者。根据结果将患者分为两组：预后不良组 (n = 33)，包括后来死亡或后来被排除在 VAD 或 HTx 之外的患者；有利结果组 (n = 45) 由那些最终脱离 ECMO 并存活下来或被认为适合接受 VAD 或 HTx 的人组成。根据单变量分析，七个危险因素很重要。基于多变量分析的回归系数，制定了RFSS：（肺功能障碍×7）+（全身感染×3）+（乳酸峰值> 3毫摩尔/升×3）+（肾功能障碍×2）+（肌酸激酶> 10 000 U/L×1）。 RFSS 为 7 或更高的患者被分配到结果较差组。 RFSS 得到了另一组 30 名患者的验证，具有良好的相关性。 RFSS 提供了一种方法来预测哪些 ECMO 支持的患者适合 VAD 植入或 HTx。
We developed a risk factor-scaling score (RFSS) to select which patients supported by extracorporeal membrane oxygenation (ECMO) were suitable for ventricular assist device (VAD) implantation or heart transplantation (HTx). A total of 78 patients supported with ECMO for more than 48 h due to cardiac origin were included in this study. Patients were categorized into two groups based on the outcomes: the poor outcome group (n = 33) consisted of for those who later died or were later excluded from VAD or HTx; the favorable outcome group (n = 45) consisted of those who were weaned off ECMO finally and survived or were deemed suitable candidates for VAD or HTx. Seven risk factors were significant according to univariate analyses. Based on the regression coefficients of multivariate analysis, the RFSS was developed: (lung dysfunction x 7) + (systemic infection x 3) + (peak lactate > 3 mmole/L x 3) + (kidney dysfunction x 2) + (creatine kinase > 10 000 U/L x 1). Patients with an RFSS of 7 or more were be allocated to the poor outcome group. The RFSS was validated by another group of 30 patients with good correlation. The RFSS provides a way to predict which ECMO-supported patients are suitable candidates for VAD implantation or HTx.