Enger, Tone Bull and Philipp, Alois and Lubnow, Matthias and Fischer, Marcus and Camboni, Daniele and Lunz, Dirk and Bein, Thomas and Mueller, Thomas (2017) Long-Term Survival in Adult Patients With Severe Acute Lung Failure Receiving Veno-Venous Extracorporeal Membrane Oxygenation. CRITICAL CARE MEDICINE, 45 (10). pp. 1718-1725. ISSN 0090-3493, 1530-0293
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Objectives: To assess long-term survival in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation and explore risk factors for long-term mortality. Design: Single-center prospective cohort study. Setting: University Hospital Regensburg, Germany. Patients: All primary cases supported with veno-venous extracorporeal membrane oxygenation from 2007 to 2016 (n = 553). Interventions: None. Measurements and Main Results: Patients were followed until January 2017. Long-term survival and predictors of long-term mortality were assessed using Kaplan-Meier survival analyses and Cox proportional hazards modeling, respectively. Two hundred eighty-six patients (52%) died during follow-up (mean follow-up 4.8 yr). Two hundred seventeen patients (39%) died during hospitalization, whereas another 69 patients (12%) died during later follow-up. Among hospital survivors, the 1-month, 3-month, 1-year, and 5-year survival rates were 99%, 95%, 86%, and 76%, respectively. Higher age, immunocompromised status, and higher Sequential Organ Failure Assessment scores were associated with long-term mortality, whereas patients with out-of-center cannulation showed improved long-term survival. Due to nonproportional hazards over time, the analysis was repeated for hospital survivors only (n = 336). Only age and immunocompromised state remained significant predictors of late mortality among hospital survivors. Lower Glasgow Outcome Scale at hospital discharge and the University Hospital Regensburg pre-extracorporeal membrane oxygenation score for predicting hospital mortality in veno-venous extracorporeal membrane oxygenation patients before extracorporeal membrane oxygenation initiation were associated with late mortality in hospital survivors (p < 0.001). Conclusions: Whereas acute illness factors may be important in prediction of hospital outcomes in veno-venous extracorporeal membrane oxygenation patients, they do not determine late mortality in hospital survivors. Preexisting morbidity and functional ability at hospital discharge may be important determinants of long-term survival in veno-venous extracorporeal membrane oxygenation patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RESPIRATORY-DISTRESS-SYNDROME; QUALITY-OF-LIFE; INTENSIVE-CARE; GENERAL-POPULATION; MORTALITY RISK; FOLLOW-UP; OUTCOMES; SEPSIS; SCORE; ARDS; acute lung injury; extracorporeal membrane oxygenation; long-term survivors; respiratory insufficiency; survival analysis |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:19 |
| Last Modified: | 01 Mar 2019 08:22 |
| URI: | https://pred.uni-regensburg.de/id/eprint/2134 |
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