PMID- 30204777
OWN - NLM
STAT- MEDLINE
DCOM- 20190226
LR  - 20190226
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 9
DP  - 2018
TI  - Complication patterns in patients undergoing venoarterial extracorporeal membrane 
      oxygenation in intensive care unit: Multiple correspondence analysis and 
      hierarchical ascendant classification.
PG  - e0203643
LID - 10.1371/journal.pone.0203643 [doi]
LID - e0203643
AB  - BACKGROUND: Treatment by venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) is widely used today, even though it is associated with high risks of 
      complications and death. While studies have focused on the relationship between 
      some of these complications and the risk of death, the relationship between 
      different complications has never been specifically examined, despite the fact 
      that the occurrence of one complication is known to favor the occurrence of 
      others. Our objective was to describe the relationship between complications in 
      patients undergoing VA-ECMO in intensive care unit (ICU) and to identify, if 
      possible, patterns of patients according to complications. METHODS AND FINDINGS: 
      As part of a retrospective cohort study, we conducted a multiple correspondence 
      analysis followed by a hierarchical ascendant classification in order to identify 
      patterns of patients according to main complications (sepsis, thromboembolic 
      event, major transfusion, major bleeding, renal replacement therapy) and in-ICU 
      death. Our cohort of 145 patients presented an in-ICU mortality rate of 50.3%. 
      Morbidity was high, with 36.5% of patients presenting three or more of the five 
      complications studied. Multiple correspondence analysis revealed a cumulative 
      inertia of 76.9% for the first three dimensions. Complications were clustered 
      together and clustered close to death, prompting the identification of four 
      patterns of patients according to complications, including one with no 
      complications. CONCLUSIONS: Our study, based on a large cohort of patients 
      undergoing VA-ECMO in ICU and presenting a mortality rate comparable to that 
      reported in the literature, identified numerous and often interrelated 
      complications. Multiple correspondence analysis and hierarchical ascendant 
      classification yielded clusters of patients and highlighted specific links 
      between some of the complications studied. Further research should be conducted 
      in this area.
FAU - Allyn, Jerome
AU  - Allyn J
AUID- ORCID: 0000-0001-8057-0393
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
AD  - Departement d'Informatique Clinique, Centre Hospitalier Universitaire de La 
      Reunion Site Felix Guyon, Saint-Denis, France.
FAU - Ferdynus, Cyril
AU  - Ferdynus C
AD  - Unite de Soutien Methodologique, Centre Hospitalier Universitaire de La Reunion, 
      Saint-Denis, France.
AD  - INSERM, CIC 1410, Saint-Pierre, France.
FAU - Lo Pinto, Hugo
AU  - Lo Pinto H
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Bouchet, Bruno
AU  - Bouchet B
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Persichini, Romain
AU  - Persichini R
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Vandroux, David
AU  - Vandroux D
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Puech, Berenice
AU  - Puech B
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
FAU - Allou, Nicolas
AU  - Allou N
AD  - Reanimation Polyvalente, Centre Hospitalier Universitaire de La Reunion Site 
      Felix Guyon, Saint-Denis, France.
AD  - Departement d'Informatique Clinique, Centre Hospitalier Universitaire de La 
      Reunion Site Felix Guyon, Saint-Denis, France.
LA  - eng
PT  - Journal Article
DEP - 20180911
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cluster Analysis
MH  - Cohort Studies
MH  - *Extracorporeal Membrane Oxygenation
MH  - Hemorrhage/*complications/diagnosis
MH  - Hospital Mortality
MH  - Humans
MH  - Intensive Care Units
MH  - Length of Stay
MH  - Middle Aged
MH  - Myocardial Infarction/therapy
MH  - Prognosis
MH  - Renal Replacement Therapy
MH  - Retrospective Studies
MH  - Sepsis/*complications/diagnosis
MH  - Shock, Cardiogenic/therapy
MH  - Thromboembolism/*complications/diagnosis
PMC - PMC6133279
COIS- The authors have declared that no competing interests exist.
EDAT- 2018/09/12 06:00
MHDA- 2019/02/27 06:00
PMCR- 2018/09/11
CRDT- 2018/09/12 06:00
PHST- 2018/04/09 00:00 [received]
PHST- 2018/08/26 00:00 [accepted]
PHST- 2018/09/12 06:00 [entrez]
PHST- 2018/09/12 06:00 [pubmed]
PHST- 2019/02/27 06:00 [medline]
PHST- 2018/09/11 00:00 [pmc-release]
AID - PONE-D-18-10642 [pii]
AID - 10.1371/journal.pone.0203643 [doi]
PST - epublish
SO  - PLoS One. 2018 Sep 11;13(9):e0203643. doi: 10.1371/journal.pone.0203643. 
      eCollection 2018.