PMID- 27044572
OWN - NLM
STAT- MEDLINE
DCOM- 20161101
LR  - 20220419
IS  - 1466-609X (Electronic)
IS  - 1364-8535 (Print)
IS  - 1364-8535 (Linking)
VI  - 20
DP  - 2016 Apr 5
TI  - In-hospital mortality and successful weaning from venoarterial extracorporeal 
      membrane oxygenation: analysis of 5,263 patients using a national inpatient 
      database in Japan.
PG  - 80
LID - 10.1186/s13054-016-1261-1 [doi]
LID - 80
AB  - BACKGROUND: The mortality rate of severely ill patients treated with venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) remains unknown because of 
      differences in patient background, clinical settings, and sample sizes between 
      studies. We determined the in-hospital mortality of VA-ECMO patients and the 
      proportion weaned from VA-ECMO using a national inpatient database in Japan. 
      METHODS: Patients aged >/= 19 years who received VA-ECMO during hospitalization for 
      cardiogenic shock, pulmonary embolism, hypothermia, poisoning, or trauma between 
      1 July 2010 and 31 March 2013 were identified, using The Japanese Diagnosis 
      Procedure Combination national inpatient database. RESULTS: The primary outcome 
      was in-hospital mortality and the secondary outcome was the proportion weaned 
      from VA-ECMO. A total of 5263 patients received VA-ECMO during the study period. 
      The majority of patients had cardiogenic shock (n = 4,658). The number of 
      patients weaned from VA-ECMO was 3389 (64.4%) and in-hospital mortality after 
      weaning from VA-ECMO was 1994 (37.9%). In-hospital mortality without cardiac 
      arrest in the cardiogenic shock group was significantly lower than that in 
      patients with cardiac arrest (70.5% vs. 77.1%, p <0.001). In the multivariable 
      logistic regression including multiple imputation, higher age and greater or 
      smaller body mass index were significantly associated with in-hospital mortality, 
      whereas hospital volume was not associated with such mortality. CONCLUSIONS: The 
      present nationwide study showed high mortality rates in patients who received 
      VA-ECMO, and in particular in patients with cardiogenic shock and in patients 
      with cardiac arrest. Weaning from VA-ECMO did not necessarily result in survival. 
      Further studies are warranted to clarify risk-adjusted mortality of VA-ECMO using 
      more detailed data on patient background.
FAU - Aso, Shotaro
AU  - Aso S
AD  - Department of Clinical Epidemiology and Health Economics, School of Public 
      Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
FAU - Matsui, Hiroki
AU  - Matsui H
AD  - Department of Clinical Epidemiology and Health Economics, School of Public 
      Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
FAU - Fushimi, Kiyohide
AU  - Fushimi K
AD  - Department of Health Policy and Informatics, Tokyo Medical and Dental University 
      Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
FAU - Yasunaga, Hideo
AU  - Yasunaga H
AD  - Department of Clinical Epidemiology and Health Economics, School of Public 
      Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. 
      yasunagah-tky@umin.ac.jp.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160405
PL  - England
TA  - Crit Care
JT  - Critical care (London, England)
JID - 9801902
SB  - IM
CIN - Crit Care. 2016 Jul 15;20(1):202. PMID: 27417697
MH  - Age Factors
MH  - Aged
MH  - Extracorporeal Membrane Oxygenation/*mortality
MH  - Female
MH  - *Hospital Mortality
MH  - Humans
MH  - Japan
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - *Survival Rate
MH  - *Weaning
PMC - PMC4820970
OTO - NOTNLM
OT  - Age factors
OT  - Cardiac arrest
OT  - Cardiogenic shock
OT  - Extracorporeal membrane oxygenation
OT  - Mortality
EDAT- 2016/04/06 06:00
MHDA- 2016/11/02 06:00
PMCR- 2016/04/05
CRDT- 2016/04/06 06:00
PHST- 2015/07/12 00:00 [received]
PHST- 2016/03/08 00:00 [accepted]
PHST- 2016/04/06 06:00 [entrez]
PHST- 2016/04/06 06:00 [pubmed]
PHST- 2016/11/02 06:00 [medline]
PHST- 2016/04/05 00:00 [pmc-release]
AID - 10.1186/s13054-016-1261-1 [pii]
AID - 1261 [pii]
AID - 10.1186/s13054-016-1261-1 [doi]
PST - epublish
SO  - Crit Care. 2016 Apr 5;20:80. doi: 10.1186/s13054-016-1261-1.