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The fourth report of the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) of the European Association for Cardiothoracic Surgery: focus on standardized outcome ratios
KM. Veen, M. Ahmed, C. Stark, L. Botta, K. Anastasiadis, A. Bernhardt, M. Berchtold-Herz, K. Caliskan, D. Reineke, K. Damman, A. Fiane, A. Gkouziouta, C. Gollmann-Tepeköylü, E. Najjar, M. Hulman, A. Iacovoni, A. Loforte, B. Merkely, F. Musumeci,...
Language English Country Germany
Document type Journal Article, Multicenter Study
PubMed
39874447
DOI
10.1093/ejcts/ezaf016
Knihovny.cz E-resources
- MeSH
- Middle Aged MeSH
- Humans MeSH
- Heart-Assist Devices * statistics & numerical data MeSH
- Registries * statistics & numerical data MeSH
- Aged MeSH
- Heart Failure mortality surgery therapy epidemiology MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
OBJECTIVES: This 4th report aimed to provide insights into patient characteristics, outcomes and standardized outcome ratios of patients implanted with durable Mechanical Circulatory Support across participating centres in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry. METHODS: All registered patients receiving durable mechanical circulatory support up to August 2024 were included. The expected number of events was predicted using penalized logistic regression. Standardized outcome ratios (Observed/Expected events) were presented in plots to assess 30-day and 1-year mortality, ischaemic stroke and major bleeding outcomes. Expected events were estimated using penalized logistic regression using demographics and comorbidities as predictors. Centres with <90% follow-up completeness were excluded from standardized outcome ratio assessment. RESULTS: Analysis included 6962 implants in 6408 patients (457 patients underwent repeated implants) registered in EUROMACS from 17 countries (32 centres) (median age: 58 years, 83% males, 17% Interagency Registry for Mechanically Assisted Circulatory Support class 1). Thirty-day mortality, major bleeding and ischaemic stroke probabilities were 9.6, 12.6% and 2.1%, respectively. Standardized mortality ratios showed variability between centres, ranging from 0 (95% CI 0-0) to 1.4 (95% CI 1.2-1.7). Higher standardized bleeding outcome ratios correlated with higher standardized ischaemic stroke ratio's (Spearman r: 0.56, P = 0.008). CONCLUSIONS: Most included centres perform as expected given the demographics and comorbidities of patients. A positive correlation was found between standardized bleeding and ischaemic stroke ratios, reflecting the need of continuously monitoring of adverse events by quality improvement programs.
Cardiac Surgery and Heart Transplantation Unit Azienda Ospedaliera San Camillo Forlanini Rome Italy
Cardiology and Cardiac Surgery Department Clinica Universidad de Navarra Pamplona Spain
Cardiothoracic Department Aristotle University AHEPA University Hospital Thessaloniki Greece
Department for Cardiothoracic Surgery Heart Center Universitätsklinikum Köln AöR Köln Germany
Department of Anesthesia and Intensive Care IRCCS San Raffaele Scientific Institute Milano Italy
Department of Cardiac Surgery Helsinki University Hospital Helsinki Finland
Department of Cardiac Surgery Herzzentrum Leipzig Leipzig Germany
Department of Cardiac Surgery Katholieke Universiteit Leuven Leuven Belgium
Department of Cardiac Surgery Klinika Kardiochirurgie NUSCH Bratislava Slovakia
Department of Cardiac Surgery Medical University of Innsbruck Innsbruck Austria
Department of Cardiac Surgery Saarland University Medical Center Homburg Germany
Department of Cardiac Surgery University Hospital Basel Basel Switzerland
Department of Cardiac Surgery Vienna Medical University Vienna Austria
Department of Cardiology Arhus University Hospital Arhus Denmark
Department of Cardiology Heart Center of the Semmelweis University
Department of Cardiology Leiden University Medical Center Leiden Netherlands
Department of Cardiothoracic and Vascular Surgery Deutsches Herzzentrum der Charité Berlin Germany
Department of Cardiothoracic Surgery Erasmus MC Rotterdam The Netherlands
Department of Cardiothoracic Surgery Rikshospitalet Oslo Norway
Department of Cardiothoracic Surgery Utrecht University Medical Center Utrecht Netherlands
Department of Cardiovascular Surgery Ege University Hospital Izmir Turkey
Department of Cardiovascular Surgery Onze Lieve Vrouwenziekenhuis Aalst Belgium
Department of Cardiovascular Surgery University Heart and Vascular Center Hamburg Hamburg Germany
Department of Cardiovascular Surgery University Hospital Bern Switzerland
Department of Cardiovascular Surgery University Hospital Freiburg Freiburg Germany
Department of Cardiovascular surgery University Hospital Hamburg Eppendorf Hamburg Germany
Department of Medicine Karolinska University Hospital Stockholm Sweden
EUROMACS EACTS House Windsor UK
IRCCS AOU di Bologna Sant'Orsola Dept of cardiac surgery San Orsola Hospital Bologna Italy
National Research Cardiac Surgery Center Astana Kazakhstan
Onassis Cardiac Surgery Center Athens Greece
Silesian Center for Heart Diseases Zabrze Poland
Universitair Medisch Centrum Groningen University of Groningen Groningen Netherlands
References provided by Crossref.org
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- $a Veen, Kevin M $u Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, The Netherlands $1 https://orcid.org/0000000328068384
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- $a OBJECTIVES: This 4th report aimed to provide insights into patient characteristics, outcomes and standardized outcome ratios of patients implanted with durable Mechanical Circulatory Support across participating centres in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry. METHODS: All registered patients receiving durable mechanical circulatory support up to August 2024 were included. The expected number of events was predicted using penalized logistic regression. Standardized outcome ratios (Observed/Expected events) were presented in plots to assess 30-day and 1-year mortality, ischaemic stroke and major bleeding outcomes. Expected events were estimated using penalized logistic regression using demographics and comorbidities as predictors. Centres with <90% follow-up completeness were excluded from standardized outcome ratio assessment. RESULTS: Analysis included 6962 implants in 6408 patients (457 patients underwent repeated implants) registered in EUROMACS from 17 countries (32 centres) (median age: 58 years, 83% males, 17% Interagency Registry for Mechanically Assisted Circulatory Support class 1). Thirty-day mortality, major bleeding and ischaemic stroke probabilities were 9.6, 12.6% and 2.1%, respectively. Standardized mortality ratios showed variability between centres, ranging from 0 (95% CI 0-0) to 1.4 (95% CI 1.2-1.7). Higher standardized bleeding outcome ratios correlated with higher standardized ischaemic stroke ratio's (Spearman r: 0.56, P = 0.008). CONCLUSIONS: Most included centres perform as expected given the demographics and comorbidities of patients. A positive correlation was found between standardized bleeding and ischaemic stroke ratios, reflecting the need of continuously monitoring of adverse events by quality improvement programs.
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