PMID- 34172365
OWN - NLM
STAT- MEDLINE
DCOM- 20220510
LR  - 20220519
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 36
IP  - 6
DP  - 2022 Jun
TI  - Gender and the Outcome of Postcardiotomy Veno-arterial Extracorporeal Membrane 
      Oxygenation.
PG  - 1678-1685
LID - S1053-0770(21)00423-7 [pii]
LID - 10.1053/j.jvca.2021.05.015 [doi]
AB  - 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.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Biancari, Fausto
AU  - Biancari F
AD  - Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Research 
      Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, 
      University of Oulu, Oulu, Finland; Department of Surgery, University of Turku, 
      Turku, Finland.
FAU - Dalen, Magnus
AU  - Dalen M
AD  - Department of Molecular Medicine and Surgery, Department of Cardiac Surgery, 
      Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
FAU - Fiore, Antonio
AU  - Fiore A
AD  - Department of Cardiothoracic Surgery, Henri Mondor University Hospital, AP-HP, 
      Paris-Est University, Creteil, France.
FAU - Dell'Aquila, Angelo M
AU  - Dell'Aquila AM
AD  - Department of Cardiothoracic Surgery, Munster University Hospital, Munster, 
      Germany.
FAU - Jonsson, Kristjan
AU  - Jonsson K
AD  - Department of Cardiac Surgery, Sahlgrenska University Hospital, Gothenburg, 
      Sweden.
FAU - Ragnarsson, Sigurdur
AU  - Ragnarsson S
AD  - Department of Cardiothoracic Surgery, University of Lund, Lund, Sweden.
FAU - Gatti, Giuseppe
AU  - Gatti G
AD  - Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy.
FAU - Gabrielli, Marco
AU  - Gabrielli M
AD  - Division of Cardiac Surgery, Ospedali Riuniti, Trieste, Italy.
FAU - Zipfel, Svante
AU  - Zipfel S
AD  - Hamburg University Heart Center, Hamburg, Germany.
FAU - Ruggieri, Vito G
AU  - Ruggieri VG
AD  - Division of Cardiothoracic and Vascular Surgery, Robert Debre University 
      Hospital, Universite Reims Champagne Ardenne, Reims, France.
FAU - Perrotti, Andrea
AU  - Perrotti A
AD  - Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean 
      Minjoz, Besancon, France.
FAU - Bounader, Karl
AU  - Bounader K
AD  - Division of Cardiothoracic and Vascular Surgery, Pontchaillou University 
      Hospital, Rennes, France.
FAU - Alkhamees, Khalid
AU  - Alkhamees K
AD  - Prince Sultan Cardiac Center, Al Hassa, Saudi Arabia.
FAU - Loforte, Antonio
AU  - Loforte A
AD  - Division of Cardiac Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 
      Bologna, Italy.
FAU - Lechiancole, Andrea
AU  - Lechiancole A
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Pol, Marek
AU  - Pol M
AD  - Institute of Clinical and Experimental Medicine, Prague, Czech Republic.
FAU - Pettinari, Matteo
AU  - Pettinari M
AD  - Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
FAU - De Keyzer, Dieter
AU  - De Keyzer D
AD  - Department of Cardiovascular Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
FAU - Vento, Antti
AU  - Vento A
AD  - Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.
FAU - Welp, Henryk
AU  - Welp H
AD  - Department of Cardiothoracic Surgery, Munster University Hospital, Munster, 
      Germany.
FAU - Fux, Thomas
AU  - Fux T
AD  - Department of Molecular Medicine and Surgery, Department of Cardiac Surgery, 
      Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
FAU - Yusuff, Hakeem
AU  - Yusuff H
AD  - Department of Intensive Care Medicine and Cardiac Surgery, Glenfield Hospital, 
      University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
FAU - Maselli, Daniele
AU  - Maselli D
AD  - Cardiac Surgery, S. Anna Hospital, Catanzaro, Italy.
FAU - Juvonen, Tatu
AU  - Juvonen T
AD  - Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Research 
      Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, 
      University of Oulu, Oulu, Finland.
FAU - Mariscalco, Giovanni
AU  - Mariscalco G
AD  - Department of Intensive Care Medicine and Cardiac Surgery, Glenfield Hospital, 
      University Hospitals of Leicester NHS Trust, Leicester, United Kingdom. 
      Electronic address: giovannimariscalco@yahoo.it.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210515
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Coronary Artery Bypass
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/etiology
OTO - NOTNLM
OT  - ECMO
OT  - cardiac surgery
OT  - complications
OT  - gender
OT  - survival
COIS- Conflict of Interest The authors declared no potential conflicts of interest with 
      respect to the research, authorship, and/or publication of this article.
EDAT- 2021/06/27 06:00
MHDA- 2022/05/11 06:00
CRDT- 2021/06/26 05:36
PHST- 2021/04/10 00:00 [received]
PHST- 2021/05/05 00:00 [revised]
PHST- 2021/05/06 00:00 [accepted]
PHST- 2021/06/27 06:00 [pubmed]
PHST- 2022/05/11 06:00 [medline]
PHST- 2021/06/26 05:36 [entrez]
AID - S1053-0770(21)00423-7 [pii]
AID - 10.1053/j.jvca.2021.05.015 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2022 Jun;36(6):1678-1685. doi: 
      10.1053/j.jvca.2021.05.015. Epub 2021 May 15.