Gender and the Outcome of Postcardiotomy Veno-arterial Extracorporeal Membrane Oxygenation
(2022) In Journal of Cardiothoracic and Vascular Anesthesia 36(6). p.1678-1685- Abstract
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... (More)
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.
(Less)
- author
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cardiac surgery, complications, ECMO, gender, survival
- in
- Journal of Cardiothoracic and Vascular Anesthesia
- volume
- 36
- issue
- 6
- pages
- 1678 - 1685
- publisher
- Elsevier
- external identifiers
-
- pmid:34172365
- scopus:85108508936
- ISSN
- 1053-0770
- DOI
- 10.1053/j.jvca.2021.05.015
- language
- English
- LU publication?
- yes
- id
- cebc64b7-6bf1-44d7-bb1f-eaeceabdeeff
- date added to LUP
- 2021-08-16 10:31:28
- date last changed
- 2024-04-20 09:22:13
@article{cebc64b7-6bf1-44d7-bb1f-eaeceabdeeff,
abstract = {{<p>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.</p>}},
author = {{Biancari, Fausto and Dalén, Magnus and Fiore, Antonio and Dell'Aquila, Angelo M. and Jónsson, Kristján and Ragnarsson, Sigurdur and Gatti, Giuseppe and Gabrielli, Marco and Zipfel, Svante and Ruggieri, Vito G. and Perrotti, Andrea and Bounader, Karl and Alkhamees, Khalid and Loforte, Antonio and Lechiancole, Andrea and Pol, Marek and Pettinari, Matteo and De Keyzer, Dieter and Vento, Antti and Welp, Henryk and Fux, Thomas and Yusuff, Hakeem and Maselli, Daniele and Juvonen, Tatu and Mariscalco, Giovanni}},
issn = {{1053-0770}},
keywords = {{cardiac surgery; complications; ECMO; gender; survival}},
language = {{eng}},
number = {{6}},
pages = {{1678--1685}},
publisher = {{Elsevier}},
series = {{Journal of Cardiothoracic and Vascular Anesthesia}},
title = {{Gender and the Outcome of Postcardiotomy Veno-arterial Extracorporeal Membrane Oxygenation}},
url = {{http://dx.doi.org/10.1053/j.jvca.2021.05.015}},
doi = {{10.1053/j.jvca.2021.05.015}},
volume = {{36}},
year = {{2022}},
}