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Mortality and cost of post-cardiotomy extracorporeal support in the United States.
- Source :
-
Perfusion . Oct2023, Vol. 38 Issue 7, p1468-1477. 10p. - Publication Year :
- 2023
-
Abstract
- Background: Extracorporeal membrane oxygenation (ECMO) has been used increasingly for cardiopulmonary rescue. Despite recent advances however, post-cardiotomy shock (PCS)-ECMO survival remains comparatively poor. We sought to evaluate outcomes and define factors that predict in-hospital mortality. Methods: We used the Nationwide Inpatient Sample (NIS) to evaluate adult hospitalizations with a primary procedure code for coronary artery bypass grafting (CABG), and/or valve procedures performed between 2013 and 2018, which also required post cardiotomy ECMO support. Patient-related factors and hospital costs were evaluated to identify those associated with in-hospital mortality. Results: There were 1,247,835 admissions for cardiac surgical procedures during the study period. Post-cardiotomy shock-ECMO support was provided in 4475 (0.3%) within the study cohort. A total of 2000 (44.7%) hospitalizations involved isolated valvular procedures, 1700 (38.0%) isolated CABG, and 775 (17.3%) involved a combination of both. Overall, in-hospital mortality was 42.1% (n = 1880). Factors significantly associated with in-hospital mortality included patients with multiple comorbidities (> 7) and those undergoing combination of valve and CABG procedures. Only 26.6% of those who survived to discharge, were discharged home independently. Conclusion: Survival to independent home discharge is rare following PCS-ECMO. Its high mortality is associated with multiple comorbidities and combination of CABG and valve surgery. [ABSTRACT FROM AUTHOR]
- Subjects :
- *CARDIAC surgery
*CORONARY artery bypass
*EXTRACORPOREAL membrane oxygenation
*MEDICAL care costs
*POSTOPERATIVE care
*PATIENTS
*HOSPITAL mortality
*RISK assessment
*HOSPITAL admission & discharge
*HOSPITAL care
*DESCRIPTIVE statistics
*DATA analysis software
*COMORBIDITY
*DISCHARGE planning
*LONGITUDINAL method
*ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 02676591
- Volume :
- 38
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Perfusion
- Publication Type :
- Academic Journal
- Accession number :
- 173121497
- Full Text :
- https://doi.org/10.1177/02676591221117355