A1 Journal article – refereed

Gender and the Outcome of Postcardiotomy Veno-arterial Extracorporeal Membrane Oxygenation




List of Authors: Biancari F., Dalén M., Fiore A., Dell'Aquila A.M., Jónsson K., Ragnarsson S., Gatti G., Gabrielli M., Zipfel S., Ruggieri V.G., Perrotti A., Bounader K., Alkhamees K., Loforte A., Lechiancole A., Pol M., Pettinari M., De Keyzer D., Vento A., Welp H., Fux T., Yusuff H., Maselli D., Juvonen T., Mariscalco G.

Publisher: W.B. Saunders

Publication year: 2021

Journal: Journal of Cardiothoracic and Vascular Anesthesia

Journal name in source: Journal of Cardiothoracic and Vascular Anesthesia

eISSN: 1532-8422

DOI: http://dx.doi.org/10.1053/j.jvca.2021.05.015


Abstract

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 scorematched 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 sur-gery 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 adoptedwith logistic regression.A total of 358 patients (mean age: 63.3§12.3 years; 29.6% female) were identified. Among 94 propensity scorematched pairs, women had ahigher hospital mortality (70.5%v56.4%, 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. Amongpropensity scorematched pairs, one-, three-, and five-year mortality were 60.6%, 65.0%, and 65.0% among men, and 71.3%, 71.3%, and74.0% 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 mortalitywere similar between the two groups.


Last updated on 2021-13-10 at 09:35