Provaznik, Zdenek and Philipp, Alois and Mueller, Thomas and Kozakov, Kostiantyn and Lunz, Dirk and Schmid, Christof and Floerchinger, Bernhard (2023) Outcome after veno-arterial extracorporeal membrane oxygenation in elderly patients: A 14-year single-center experience. ARTIFICIAL ORGANS, 47 (4). pp. 740-748. ISSN 0160-564X, 1525-1594
Full text not available from this repository. (Request a copy)Abstract
Background Use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in elderly patients is controversial because of presumed poor outcome. Our primary aim was to determine the influence of advanced age on short- and long-term outcome; the secondary aim was to analyze risk factors for impaired outcome. Methods Between January 2006 and June 2020, 645 patients underwent VA-ECMO implantation in our department. The patients were categorized into four groups:<50, 50-59.9, 60-69.9 and >= 70 years old. Data were retrospectively analyzed for short- and long-term outcome. Risk factors for in-hospital mortality and mortality during follow-up were assessed using multivariate regression analysis. Results VA-ECMO support duration was comparable in all age groups (median 3 days). Weaning rates were 60.8%/n = 104 (<50 years), 51.4%/n = 90 (50-59.9 years), 58.8%/n = 107 (60-69.9), and 67.5%/n = 79 (>= 70, p = 0.048). Hospital mortality was highest in the patients aged 50-59.9 years (68%/n = 119), but not in the elderly patients (60-69.9, >= 70:62.1%/n = 113, 58,1%/n = 68). At discharge, the cerebral performance category scores were superior in the patients <50 years. Multivariate logistic regression analysis revealed chronic kidney failure requiring hemodialysis, duration of cardiopulmonary resuscitation, and elevated blood lactate levels before VA-ECMO, but not age as predictors of in-hospital mortality. Cox's regression disclosed age as relevant risk factor for death during follow-up. The patients' physical ability was comparable in all age groups. Conclusion VA-ECMO support should not be declined in patients only because of advanced age. Mortality and neurological status at hospital discharge and during follow-up were comparable in all age groups.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FAILURE; SURVIVAL; ADULTS; SHOCK; ECMO; extracorporeal membrane oxygenation; long-term outcome; low cardiac output; resuscitation; survival |
| 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: | Petra Gürster |
| Date Deposited: | 01 Sep 2023 07:44 |
| Last Modified: | 01 Sep 2023 07:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/56840 |
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