PMID- 36730984
OWN - NLM
STAT- MEDLINE
DCOM- 20230403
LR  - 20240402
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Print)
IS  - 1058-2916 (Linking)
VI  - 69
IP  - 4
DP  - 2023 Apr 1
TI  - Society for Cardiovascular Angiography and Interventions Shock Classification to 
      Stratify Outcomes of Extracorporeal Membrane Oxygenation.
PG  - 352-359
LID - 10.1097/MAT.0000000000001813 [doi]
AB  - We applied the Society for Cardiovascular Angiography and Interventions (SCAI) 
      schema to cardiogenic shock (CS) patients treated with venoarterial 
      extracorporeal membrane oxygenation (VA-ECMO) to assess performance in this high 
      acuity group of patients. Records of adult patients receiving VA-ECMO for CS at 
      our institution from 01/2015 to 12/2019 were reviewed. Post-cardiotomy and 
      noncardiogenic shock patients were excluded. A total of 245 patients were 
      included, with a median age of 59 years [IQR: 48-67]; 159 (65%) were male. There 
      were 34 (14%) patients in Stage C, 82 (33%) in D, and 129 (53%) in E. Of E 
      patients, 88 (68%) were undergoing cardiopulmonary resuscitation. Median ECMO 
      duration decreased with stage (C:7, D:6, E:4 days, P < 0.001). In-hospital 
      mortality increased (C:35%, D:56%, E:71%, P < 0.001) and myocardial recovery 
      decreased with stage (C:65%, D:35%, E:30%, P < 0.001). Acute kidney injury 
      (C:35%, D:45%, E:54%, P = 0.045), acute liver failure (C:32%, D:66%, E:76%, P < 
      0.001), and infection (C:35%, D:28%, E:16%, P = 0.004) varied among groups. 
      Multivariable analysis revealed age (HR=1.02), male sex (HR=0.62), and E 
      classification (HR=2.69) as independently associated with 1-year mortality. 
      Competing-risks regression identified D (SHR=0.53) and E classification 
      (SHR=0.45) as inversely associated with myocardial recovery. In patients treated 
      with VA-ECMO for CS, the SCAI classification provided robust risk stratification.
CI  - Copyright (c) ASAIO 2022.
FAU - Mehta, Sanket
AU  - Mehta S
AD  - From the Department of Surgery, Division of Cardiothoracic and Vascular Surgery, 
      Columbia University Medical Center.
FAU - Fried, Justin
AU  - Fried J
AD  - Division of Cardiology, Department of Medicine, Columbia University Medical 
      Center, New York, NY, USA.
FAU - Nemeth, Samantha
AU  - Nemeth S
AUID- ORCID: 0000-0002-2441-4430
AD  - Center of Innovation and Outcomes Research, Department of Surgery, Columbia 
      University.
FAU - Kurlansky, Paul
AU  - Kurlansky P
AD  - From the Department of Surgery, Division of Cardiothoracic and Vascular Surgery, 
      Columbia University Medical Center.
AD  - Center of Innovation and Outcomes Research, Department of Surgery, Columbia 
      University.
FAU - Kaku, Yuji
AU  - Kaku Y
AD  - From the Department of Surgery, Division of Cardiothoracic and Vascular Surgery, 
      Columbia University Medical Center.
FAU - Melehy, Andrew
AU  - Melehy A
AD  - From the Department of Surgery, Division of Cardiothoracic and Vascular Surgery, 
      Columbia University Medical Center.
FAU - Char, Steven
AU  - Char S
AUID- ORCID: 0000-0001-9868-3695
AD  - From the Department of Surgery, Division of Cardiothoracic and Vascular Surgery, 
      Columbia University Medical Center.
FAU - Masoumi, Amirali
AU  - Masoumi A
AD  - Division of Cardiology, Department of Medicine, Columbia University Medical 
      Center, New York, NY, USA.
FAU - Sayer, Gabriel
AU  - Sayer G
AD  - Center of Innovation and Outcomes Research, Department of Surgery, Columbia 
      University.
FAU - Uriel, Nir
AU  - Uriel N
AD  - Division of Cardiology, Department of Medicine, Columbia University Medical 
      Center, New York, NY, USA.
FAU - Takeda, Koji
AU  - Takeda K
AD  - From the Department of Surgery, Division of Cardiothoracic and Vascular Surgery, 
      Columbia University Medical Center.
LA  - eng
GR  - T35 HL007616/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20221025
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Adult
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Aged
MH  - Female
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Shock, Cardiogenic/therapy
MH  - *Cardiopulmonary Resuscitation
MH  - Hospital Mortality
MH  - Myocardium
MH  - Retrospective Studies
PMC - PMC10065877
MID - NIHMS1831426
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2023/02/03 06:00
MHDA- 2023/04/03 06:42
PMCR- 2024/04/01
CRDT- 2023/02/02 16:34
PHST- 2023/04/03 06:42 [medline]
PHST- 2023/02/03 06:00 [pubmed]
PHST- 2023/02/02 16:34 [entrez]
PHST- 2024/04/01 00:00 [pmc-release]
AID - 00002480-202304000-00003 [pii]
AID - 10.1097/MAT.0000000000001813 [doi]
PST - ppublish
SO  - ASAIO J. 2023 Apr 1;69(4):352-359. doi: 10.1097/MAT.0000000000001813. Epub 2022 
      Oct 25.