Item type: | Article | ||||
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Journal or Publication Title: | Critical Care Medicine | ||||
Publisher: | Lippincott | ||||
Place of Publication: | PHILADELPHIA | ||||
Volume: | 45 | ||||
Number of Issue or Book Chapter: | 10 | ||||
Page Range: | pp. 1718-1725 | ||||
Date: | 2017 | ||||
Institutions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II | ||||
Identification Number: |
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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 | ||||
Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
Status: | Published | ||||
Refereed: | Yes, this version has been refereed | ||||
Created at the University of Regensburg: | Yes | ||||
Item ID: | 39747 |
Abstract
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 ...
Abstract
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.
Metadata last modified: 25 Nov 2020 15:47