PMID- 33458635
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220420
IS  - 2589-790X (Electronic)
IS  - 2589-790X (Linking)
VI  - 3
IP  - 1
DP  - 2021 Jan
TI  - Predicting Survival After VA-ECMO for Refractory Cardiogenic Shock: Validating 
      the SAVE Score.
PG  - 71-81
LID - 10.1016/j.cjco.2020.09.011 [doi]
AB  - BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is used 
      increasingly to support patients who are in cardiogenic shock. Due to the risk of 
      complications, prediction models may aid in identifying patients who would 
      benefit most from VA-ECMO. One such model is the Survival After Veno-Arterial 
      Extracorporeal Membrane Oxygenation (SAVE) score. Therefore, we wanted to 
      validate the utility of the SAVE score in a contemporary cohort of adult 
      patients. METHODS: Retrospective data were extracted from electronic health 
      records of 120 patients with cardiogenic shock supported with VA-ECMO between 
      2011 and 2018. The SAVE score was calculated for each patient to predict survival 
      to hospital discharge. We assessed the SAVE score calibration by comparing 
      predicted vs observed survival at discharge. We assessed discrimination with the 
      area under the receiver operating curve using logistic regression. RESULTS: A 
      total of 45% of patients survived to hospital discharge. Survivors had a 
      significantly higher mean SAVE score (-9.3 +/- 4.1 in survivors vs -13.1 +/- 4.4, 
      respectively; P = 0.001). SAVE score discrimination was adequate (c = 0.77; 95% 
      confidence interval 0.69-0.86; P < 0.001). SAVE score calibration was limited, as 
      observed survival rates for risk classes II-V were higher in our cohort (II: 67% 
      vs 58%; III: 78% vs 42%; IV: 61% vs 30%; and V: 29% vs 18%). CONCLUSIONS: The 
      SAVE score underestimates survival in a contemporary North American cohort of 
      adult patients with cardiogenic shock. Its inaccurate performance could lead to 
      denying ECMO support to patients deemed to be too high risk. Further studies are 
      needed to validate additional predictive models for patients requiring VA-ECMO.
CI  - (c) 2020 Canadian Cardiovascular Society. Published by Elsevier Inc.
FAU - Amin, Faizan
AU  - Amin F
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
AD  - Ted Roger's Center for Heart Research, Toronto, Ontario, Canada.
FAU - Lombardi, Julia
AU  - Lombardi J
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
FAU - Alhussein, Mosaad
AU  - Alhussein M
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
AD  - Ted Roger's Center for Heart Research, Toronto, Ontario, Canada.
FAU - Posada, Juan Duero
AU  - Posada JD
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
AD  - Ted Roger's Center for Heart Research, Toronto, Ontario, Canada.
FAU - Suszko, Adrian
AU  - Suszko A
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
FAU - Koo, Margaret
AU  - Koo M
AD  - University of Toronto, Toronto, Ontario, Canada.
FAU - Fan, Eddy
AU  - Fan E
AD  - Interdepartmental Division of Critical Care Medicine and Institute for Health 
      Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, 
      Canada.
AD  - University Health Network, Toronto, Ontario, Canada.
FAU - Ross, Heather
AU  - Ross H
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
AD  - Ted Roger's Center for Heart Research, Toronto, Ontario, Canada.
FAU - Rao, Vivek
AU  - Rao V
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
FAU - Alba, Ana Carolina
AU  - Alba AC
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
AD  - Ted Roger's Center for Heart Research, Toronto, Ontario, Canada.
FAU - Billia, Filio
AU  - Billia F
AD  - Peter Munk Cardiac Centre, Toronto, Ontario, Canada.
AD  - Ted Roger's Center for Heart Research, Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20200916
PL  - United States
TA  - CJC Open
JT  - CJC open
JID - 101763635
PMC - PMC7801193
EDAT- 2021/01/19 06:00
MHDA- 2021/01/19 06:01
PMCR- 2020/09/16
CRDT- 2021/01/18 05:36
PHST- 2020/08/21 00:00 [received]
PHST- 2020/09/04 00:00 [accepted]
PHST- 2021/01/18 05:36 [entrez]
PHST- 2021/01/19 06:00 [pubmed]
PHST- 2021/01/19 06:01 [medline]
PHST- 2020/09/16 00:00 [pmc-release]
AID - S2589-790X(20)30145-1 [pii]
AID - 10.1016/j.cjco.2020.09.011 [doi]
PST - epublish
SO  - CJC Open. 2020 Sep 16;3(1):71-81. doi: 10.1016/j.cjco.2020.09.011. eCollection 
      2021 Jan.