Title |
Liver function predicts survival in patients undergoing extracorporeal membrane oxygenation following cardiovascular surgery
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Published in |
Critical Care, March 2016
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DOI | 10.1186/s13054-016-1242-4 |
Pubmed ID | |
Authors |
Christian Roth, Lore Schrutka, Christina Binder, Lukas Kriechbaumer, Gottfried Heinz, Irene M. Lang, Gerald Maurer, Herbert Koinig, Barbara Steinlechner, Alexander Niessner, Klaus Distelmaier, Georg Goliasch |
Abstract |
Extracorporeal membrane oxygenation (ECMO) represents a valuable and rapidly evolving therapeutic option in patients with severe heart or lung failure following cardiovascular surgery. However, despite significant advances in ECMO techniques and management, prognosis remains poor and accurate risk stratification challenging. We therefore evaluated the predictive value of liver function variables on all-cause mortality in patients undergoing venoarterial ECMO support after cardiovascular surgery. We included into our single-center registry a total of 240 patients undergoing venoarterial ECMO therapy following cardiovascular surgery at a university-affiliated tertiary care center. The median follow-up was 37 months (interquartile range 19-67 months), and a total of 156 patients (65 %) died. Alkaline phosphatase and total bilirubin were the strongest predictors for 30-day mortality, with adjusted hazard ratios (HRs) per 1-standard deviation increase of 1.36 (95 % confidence interval [CI] 1.10-1.68; P = 0.004) and 1.22 (95 % CI 1.07-1.40; P = 0.004), respectively. The observed associations persisted for long-term mortality, with adjusted HRs of 1.27 (95 % CI 1.03-1.56; P = 0.023) for alkaline phosphatase and 1.22 (95 % CI 1.07-1.39; P = 0.003) for total bilirubin. The present study demonstrates that elevated values of alkaline phosphatase and total bilirubin are sensitive parameters for predicting the short-term and long-term outcomes of ECMO patients. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 11 | 33% |
Spain | 2 | 6% |
United Kingdom | 2 | 6% |
Brazil | 1 | 3% |
Grenada | 1 | 3% |
Saudi Arabia | 1 | 3% |
Japan | 1 | 3% |
Netherlands | 1 | 3% |
Colombia | 1 | 3% |
Other | 1 | 3% |
Unknown | 11 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 25 | 76% |
Practitioners (doctors, other healthcare professionals) | 5 | 15% |
Science communicators (journalists, bloggers, editors) | 2 | 6% |
Scientists | 1 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 58 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 7 | 12% |
Professor > Associate Professor | 6 | 10% |
Student > Bachelor | 6 | 10% |
Student > Doctoral Student | 5 | 9% |
Other | 5 | 9% |
Other | 11 | 19% |
Unknown | 18 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 30 | 52% |
Nursing and Health Professions | 2 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
Arts and Humanities | 1 | 2% |
Chemical Engineering | 1 | 2% |
Other | 1 | 2% |
Unknown | 22 | 38% |