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Validation of Prognostic Scores in Extracorporeal Life Support: A Multi-Centric Retrospective Study
Fisser, Christoph, Rincon-Gutierrez, Luis Alberto, Enger, Tone Bull, Taccone, Fabio Silvio, Broman, Lars Mikael
, Belliato, Mirko, Nobile, Leda, Pappalardo, Federico
und Malfertheiner, Maximilian V.
(2021)
Validation of Prognostic Scores in Extracorporeal Life Support: A Multi-Centric Retrospective Study.
Membranes 2021 (11,84), S. 1-12.
Veröffentlichungsdatum dieses Volltextes: 28 Jan 2021 09:56
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.44467
Zusammenfassung
Multiple prognostic scores have been developed for both veno-arterial (VA) and veno-venous (VV) extracorporeal membrane oxygenation (ECMO), mostly in single-center cohorts. The aim of this study was to compare and validate different prediction scores in a large multicenter ECMO-population. Methods: Data from five ECMO centers included 300 patients on VA and 329 on VV ECMO support (March 2008 to ...
Multiple prognostic scores have been developed for both veno-arterial (VA) and veno-venous (VV) extracorporeal membrane oxygenation (ECMO), mostly in single-center cohorts. The aim of this study was to compare and validate different prediction scores in a large multicenter ECMO-population. Methods: Data from five ECMO centers included 300 patients on VA and 329 on VV ECMO support (March 2008 to November 2016). Different prognostic scores were compared between survivors and non-survivors: APACHE II, SOFA, SAPS II in all patients; SAVE, modified SAVE and MELD-XI in VA ECMO; RESP, PRESET, ROCH and PRESERVE in VV ECMO. Model performance was compared using receiver-operating-curve analysis and assessment of model calibration. Survival was assessed at intensive care unit discharge. Results: The main indication for VA ECMO was cardiogenic shock; overall survival was 51%. ICU survivors had higher Glasgow Coma Scale scores and pH, required cardiopulmonary resuscitation (CPR) less frequently, had lower lactate levels and shorter ventilation time pre-ECMO at baseline. The best discrimination between survivors and non-survivors was observed with the SAPS II score (area under the curve [AUC] of 0.73 (95% CI 0.67-0.78)). The main indication for VV ECMO was pneumonia; overall survival was 60%. Lower PaCO2, higher pH, lower lactate and lesser need for CPR were observed among survivors. The best discrimination between survivors and non-survivors was observed with the PRESET score (AUC 0.66 (95% CI 0.60-0.72)). Conclusion: The prognostic performance of most scores was moderate in ECMO patients. The use of such scores to decide about ECMO implementation in potential candidates should be discouraged.
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| Dokumentenart | Artikel | ||||
| Titel eines Journals oder einer Zeitschrift | Membranes | ||||
| Verlag: | MDPI | ||||
|---|---|---|---|---|---|
| Ort der Veröffentlichung: | BASEL | ||||
| Band: | 2021 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 11,84 | ||||
| Seitenbereich: | S. 1-12 | ||||
| Datum | 24 Januar 2021 | ||||
| Institutionen | Medizin > Lehrstuhl für Innere Medizin II | ||||
| Identifikationsnummer |
| ||||
| Stichwörter / Keywords | ; ECMO; score; RESP score; SAVE score; validation; ECLS | ||||
| Dewey-Dezimal-Klassifikation | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status | Veröffentlicht | ||||
| Begutachtet | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden | Ja | ||||
| URN der UB Regensburg | urn:nbn:de:bvb:355-epub-444671 | ||||
| Dokumenten-ID | 44467 |
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