PMID- 33470639
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 67
IP  - 8
DP  - 2021 Aug 1
TI  - Disseminated Intravascular Coagulation Score Is Related to Short-term Mortality 
      in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation After 
      Cardiac Surgery.
PG  - 891-898
LID - 10.1097/MAT.0000000000001333 [doi]
AB  - Disseminated intravascular coagulation (DIC) score is associated with short-term 
      mortality in various conditions but has not been studied in postcardiotomy 
      cardiogenic shock (PCS) patients supported with venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO). The objective of this study was to evaluate the 
      relationship between DIC score at day 1 from VA-ECMO initiation and short-term 
      mortality. We included all PCS patients supported with VA-ECMO at the Beijing 
      Anzhen Hospital between January 2015 and December 2018. Multivariable logistic 
      regression analysis was performed to assess the relationship between DIC score at 
      day 1 and in-hospital mortality, and adjust for potential confounding variables. 
      Of 222 PCS patients treated with VA-ECMO, 145 (65%) patients were weaned from 
      VA-ECMO, and median (IQR) ECMO support duration was five (3-6) days. In-hospital 
      mortality was 53%. The median (IQR) DIC score at day 1 was five (4-6). Patients 
      with DIC score >/=5 at day 1 (overt DIC) had higher in-hospital mortality as 
      compared with patients with DIC score <5 (64% vs. 22%; P < 0.001). After 
      adjusting for age, sex, ECMO indication, and peak serum lactate, a one-point rise 
      in DIC score [OR, 2.20; 95% confidence intervals (CI), 1.64-2.95] or DIC score >/=5 
      at day 1 (OR, 4.98; 95% CI, 2.42-10.24) was associated with an increased risk of 
      in-hospital mortality. The area under the receiver operating characteristic curve 
      for DIC score at day 1 was 0.76 (95% CI, 0.69-0.82). Our study suggests that DIC 
      score at day 1 is associated with short-term mortality in patients undergoing 
      VA-ECMO after cardiac surgery, independent of age, sex, disease characteristics, 
      and severity of illness.
CI  - Copyright (c) ASAIO 2021.
FAU - Wang, Liangshan
AU  - Wang L
AD  - From the Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and 
      Blood Vessels Diseases, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, China.
FAU - Shao, Juanjuan
AU  - Shao J
AD  - From the Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and 
      Blood Vessels Diseases, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, China.
FAU - Fan, Eddy
AU  - Fan E
AD  - Interdepartmental Division of Critical Care Medicine, University of Toronto, 
      Toronto, ON, Canada.
FAU - Jia, Ming
AU  - Jia M
AD  - From the Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and 
      Blood Vessels Diseases, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, China.
FAU - Wang, Hong
AU  - Wang H
AD  - From the Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and 
      Blood Vessels Diseases, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, China.
FAU - Hou, Xiaotong
AU  - Hou X
AD  - From the Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung, and 
      Blood Vessels Diseases, Beijing Anzhen Hospital, Capital Medical University, 
      Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - *Disseminated Intravascular Coagulation/etiology
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Hospital Mortality
MH  - Humans
MH  - Shock, Cardiogenic/etiology
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2021/01/21 06:00
MHDA- 2021/10/16 06:00
CRDT- 2021/01/20 11:31
PHST- 2021/01/21 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2021/01/20 11:31 [entrez]
AID - 00002480-202108000-00011 [pii]
AID - 10.1097/MAT.0000000000001333 [doi]
PST - ppublish
SO  - ASAIO J. 2021 Aug 1;67(8):891-898. doi: 10.1097/MAT.0000000000001333.