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Gender and the Outcome of Postcardiotomy Veno-arterial Extracorporeal Membrane Oxygenation
F. Biancari, M. Dalén, A. Fiore, AM. Dell'Aquila, K. Jónsson, S. Ragnarsson, G. Gatti, M. Gabrielli, S. Zipfel, VG. Ruggieri, A. Perrotti, K. Bounader, K. Alkhamees, A. Loforte, A. Lechiancole, M. Pol, M. Pettinari, D. De Keyzer, A. Vento, H....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- dospělí MeSH
- kardiochirurgické výkony * škodlivé účinky MeSH
- kardiogenní šok etiologie MeSH
- koronární bypass MeSH
- lidé středního věku MeSH
- lidé MeSH
- mimotělní membránová oxygenace * metody MeSH
- mortalita v nemocnicích MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
OBJECTIVE: There is a paucity of sex-specific data on patients' postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO). The present study sought to assess this issue in a multicenter study. DESIGN: Retrospective, propensity score-matched analysis of an international registry. SETTING: Multicenter study, tertiary university hospitals. PARTICIPANTS: Data on adult patients undergoing postcardiotomy VA-ECMO. MEASUREMENTS AND MAIN RESULTS: Between January 2010 and March 2018, patients treated with postcardiotomy VA-ECMO at 17 cardiac surgery centers were analyzed. Index procedures considered were coronary artery bypass graft surgery, isolated valve surgery, their combination, and proximal aortic root surgery. Hospital and five-year mortality constituted the endpoints of interest. Propensity score matching was adopted with logistic regression. A total of 358 patients (mean age: 63.3 ± 12.3 years; 29.6% female) were identified. Among 94 propensity score-matched pairs, women had a higher hospital mortality (70.5% v 56.4%, p = 0.049) compared with men. Logistic regression analysis showed that women (odds ratio [OR], 1.87; 95% confidence interval [CI] 1.10-3.16), age (OR, 1.06; 95%CI 1.04-1.08) and pre-ECMO arterial lactate (OR, 1.09; 95%CI 1.04-1.16) were independent predictors of hospital mortality. No differences between female and male patients were observed for other outcomes. Among propensity score-matched pairs, one-, three-, and five-year mortality were 60.6%, 65.0%, and 65.0% among men, and 71.3%, 71.3%, and 74.0% among women, respectively (p = 0.110, adjusted hazard ratio, 1.27; 95%CI 0.96-1.66). CONCLUSIONS: In postcardiotomy VA-ECMO, female patients demonstrated higher hospital mortality than men. Morbidity and late mortality were similar between the two groups.
Cardiac Surgery S Anna Hospital Catanzaro Italy
Cardiothoracic Department University Hospital of Udine Udine Italy
Department of Cardiac Surgery Sahlgrenska University Hospital Gothenburg Sweden
Department of Cardiothoracic Surgery Münster University Hospital Münster Germany
Department of Cardiothoracic Surgery University of Lund Lund Sweden
Department of Cardiovascular Surgery Ziekenhuis Oost Limburg Genk Belgium
Department of Surgery University of Turku Turku Finland
Department of Thoracic and Cardio Vascular Surgery University Hospital Jean Minjoz Besançon France
Division of Cardiac Surgery IRCCS Azienda Ospedaliero Universitaria di Bologna Bologna Italy
Division of Cardiac Surgery Ospedali Riuniti Trieste Italy
Division of Cardiothoracic and Vascular Surgery Pontchaillou University Hospital Rennes France
Hamburg University Heart Center Hamburg Germany
Heart and Lung Center Helsinki University Hospital Helsinki Finland
Institute of Clinical and Experimental Medicine Prague Czech Republic
Citace poskytuje Crossref.org
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- $a Biancari, Fausto $u Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Research Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Surgery, University of Turku, Turku, Finland
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- $a Gender and the Outcome of Postcardiotomy Veno-arterial Extracorporeal Membrane Oxygenation / $c F. Biancari, M. Dalén, A. Fiore, AM. Dell'Aquila, K. Jónsson, S. Ragnarsson, G. Gatti, M. Gabrielli, S. Zipfel, VG. Ruggieri, A. Perrotti, K. Bounader, K. Alkhamees, A. Loforte, A. Lechiancole, M. Pol, M. Pettinari, D. De Keyzer, A. Vento, H. Welp, T. Fux, H. Yusuff, D. Maselli, T. Juvonen, G. Mariscalco
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- $a OBJECTIVE: There is a paucity of sex-specific data on patients' postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO). The present study sought to assess this issue in a multicenter study. DESIGN: Retrospective, propensity score-matched analysis of an international registry. SETTING: Multicenter study, tertiary university hospitals. PARTICIPANTS: Data on adult patients undergoing postcardiotomy VA-ECMO. MEASUREMENTS AND MAIN RESULTS: Between January 2010 and March 2018, patients treated with postcardiotomy VA-ECMO at 17 cardiac surgery centers were analyzed. Index procedures considered were coronary artery bypass graft surgery, isolated valve surgery, their combination, and proximal aortic root surgery. Hospital and five-year mortality constituted the endpoints of interest. Propensity score matching was adopted with logistic regression. A total of 358 patients (mean age: 63.3 ± 12.3 years; 29.6% female) were identified. Among 94 propensity score-matched pairs, women had a higher hospital mortality (70.5% v 56.4%, p = 0.049) compared with men. Logistic regression analysis showed that women (odds ratio [OR], 1.87; 95% confidence interval [CI] 1.10-3.16), age (OR, 1.06; 95%CI 1.04-1.08) and pre-ECMO arterial lactate (OR, 1.09; 95%CI 1.04-1.16) were independent predictors of hospital mortality. No differences between female and male patients were observed for other outcomes. Among propensity score-matched pairs, one-, three-, and five-year mortality were 60.6%, 65.0%, and 65.0% among men, and 71.3%, 71.3%, and 74.0% among women, respectively (p = 0.110, adjusted hazard ratio, 1.27; 95%CI 0.96-1.66). CONCLUSIONS: In postcardiotomy VA-ECMO, female patients demonstrated higher hospital mortality than men. Morbidity and late mortality were similar between the two groups.
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