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ABSTRACT: Background
Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score for in-hospital mortality for cardiogenic shock patients who received VA-ECMO after isolated CABG.Methods
Retrospective cohort study of consecutive CABG patients supported with VA-ECMO (n?=?166) at the Beijing Anzhen Hospital between February 2004 and March 2017.Results
One hundred and six patients (64%) could be weaned from VA-ECMO, and 74 patients (45%) survived to hospital discharge. On the basis of multivariable logistic regression analyses, the pRedicting mortality in patients undergoing veno-arterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (REMEMBER) score was created with six pre-ECMO parameters: older age, left main coronary artery disease, inotropic score >?75, CK-MB >?130?IU/L, serum creatinine >?150?umol/L, and platelet count 9/L. Four risk classes, namely class I (REMEMBER score 0-13), class II (14-19), class III (20-25), and class IV (>?25) with their corresponding mortality (13%, 55%, 70%, and 94%, respectively), were identified. The area under the receiver operating characteristic curve 0.85(95% CI 0.79-0.91) for the REMEMBER score was better than those for the SOFA, SAVE, EuroSCORE, and ENCOURAGE scores in this population.Conclusions
The REMEMBER score might help clinicians at bedside to predict in-hospital mortality for patients receiving VA-ECMO after isolated CABG for refractory cardiogenic shock. Prospective studies are needed to externally validate this scoring system.
SUBMITTER: Wang L
PROVIDER: S-EPMC6330483 | biostudies-literature | 2019 Jan
REPOSITORIES: biostudies-literature
Critical care (London, England) 20190111 1
<h4>Background</h4>Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score for in-hospital mortality for cardiogenic shock patients who received VA-ECMO after isolated CABG.<h4>Methods</h4>Retrospective cohort study of consecutive CABG patients supported with VA-ECMO (n = 166) at the Beijing Anzhen Hospital between February 2004 an ...[more]