Risk Prediction Model of In-hospital Mortality in Patients With Myocardial Infarction Treated With Venoarterial Extracorporeal Membrane Oxygenation

被引：17

作者：

Choi, Ki Hong ^{[1
]}

Yang, Jeong Hoon ^{[1
,2
]}

Park, Taek Kyu ^{[1
]}

Lee, Joo Myung ^{[1
]}

Bin Song, Young ^{[1
]}

Hahn, Joo-Yong ^{[1
]}

Choi, Seung-Hyuk ^{[1
]}

Choi, Jin-Ho ^{[1
,3
]}

Cho, Yang Hyun ^{[4
]}

Sung, Kiick ^{[4
]}

Carriere, Keumhee ^{[5
,6
]}

Ahn, Joonghyun ^{[6
]}

Gwon, Hyeon-Cheol ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Heart Vasc Stroke Inst,Dept Med,Div Cardiol, Seoul, South Korea

[2] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Crit Care Med, Seoul, South Korea

[3] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Emergency Med, Seoul, South Korea

[4] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Thorac & Cardiovasc Surg, Seoul, South Korea

[5] Univ Alberta, Dept Math & Stat Sci, Edmonton, AB, Canada

[6] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Biostat & Clin Epidemiol Ctr, Seoul, South Korea

来源：

REVISTA ESPANOLA DE CARDIOLOGIA | 2019年 / 72卷 / 09期

关键词：

Acute myocardial infarction; Extracorporeal circulation; Risk assessment; PERCUTANEOUS CORONARY INTERVENTION; REFRACTORY CARDIOGENIC-SHOCK; MECHANICAL CIRCULATORY SUPPORT; CARDIAC-ARREST; CLINICAL-OUTCOMES; TRENDS; MANAGEMENT; DISEASE; LIFE; ECMO;

D O I：

10.1016/j.rec.2018.06.010

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction and objectives: There are limited data to develop a risk prediction model of in-hospital mortality for acute myocardial infarction (AMI) patients treated with venoarterial (VA)-extracorporeal membrane oxygenation (ECMO). We aimed to develop a risk prediction model for in-hospital mortality in patients with AMI who were treated with VA-ECMO. Methods: A total of 145 patients with AMI who underwent VA-ECMO between May 2004 and April 2016 were included from the Samsung Medical Center ECMO registry. The primary outcome was in-hospital mortality. To develop a new predictive scoring system, named the AMI-ECMO score, backward stepwise elimination and beta coefficient-based scoring were used based on logistic regression analyses. The leave-one-out cross-validation method was performed for internal validation. Results: In-hospital mortality occurred in 69 patients (47.6%). On multivariable logistic regression analysis, the AMI-ECMO score comprised 6 pre-ECMO or angiographic parameters: age > 65 years, body mass index > 25 kg/m(2), Glasgow coma score < 6, lactic acid > 8 mmol/L, anterior wall infarction, and no or failed revascularization. The C-statistic value of AMI-ECMO score for predicting in-hospital mortality was 0.880 (95% CI, 0.820-0.940). The incidence of in-hospital mortality after VA-ECMO insertion was 6.2%, 28.1%, 51.6%, and 93.8% for AMI-ECMO score quartiles (0 to 16, 17 to 19, 20 to 26, and > 26), respectively (P<.001 for trend). The AMI-ECMO scores were also significantly associated with the estimated rate of all-cause mortality during follow-up (per 1 increase, HR, 1.11; 95% CI, 1.08-1.14; P<.001). Conclusions: The AMI-ECMO score can help predict early prognosis in AMI patients who undergo VA-ECMO. (C) 2018 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.

引用

页码：724 / 731

页数：8

共 32 条

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