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Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score

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机构: [1]Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China. [2]Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada. [3]Division of Neonatology, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, Delaware, USA. [4]Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, NY, USA.
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关键词: Cardiogenic shock Venoarterial extracorporeal membrane oxygenation Coronary artery bypass grafting pRedicting mortality in patients undergoing veno-arterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (REMEMBER) score Mortality

摘要:
BackgroundPrediction 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.MethodsRetrospective cohort study of consecutive CABG patients supported with VA-ECMO (n=166) at the Beijing Anzhen Hospital between February 2004 and March 2017.ResultsOne 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 >130IU/L, serum creatinine >150umol/L, and platelet count <100x10(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.ConclusionsThe 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.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 3 区 危重病医学
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 危重病医学
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出版当年[2017]版:
Q1 CRITICAL CARE MEDICINE
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Q1 CRITICAL CARE MEDICINE

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第一作者机构: [1]Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China.
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通讯机构: [1]Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China.
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