TY - JOUR
T1 - Clinical picture of the duration of venoarterial extracorporeal membrane oxygenation
T2 - analysis from JROAD-DPC
AU - Sakamoto, Kazuo
AU - Matoba, Tetsuya
AU - Nakai, Michikazu
AU - Tahara, Yoshio
AU - Nakashima, Takahiro
AU - Hosoda, Hayato
AU - Miyamoto, Yoshihiro
AU - Nishimura, Kunihiro
AU - Sumita, Yoko
AU - Yagi, Tsukasa
AU - Ichimura, Kenzo
AU - Yonemoto, Naohiro
AU - Tachibana, Eizo
AU - Nagao, Ken
AU - Ikeda, Takanori
AU - Sato, Naoki
AU - Tsutsui, Hiroyuki
N1 - Publisher Copyright:
© 2022, Springer Japan KK, part of Springer Nature.
PY - 2023/2
Y1 - 2023/2
N2 - Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been widely used for critically ill patients all over the world; however, comprehensive survey regarding the relationship between VA-ECMO duration and prognosis is limited. We conducted a survey of VA-ECMO patients in the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC), which was a health insurance claim database study among cardiovascular centers associated with the Japan Circulation Society, between April 2012 and March 2016. Out of 13,542 VA-ECMO patients, we analyzed 5766 cardiovascular patients treated with VA-ECMO. 68% patients used VA-ECMO only for 1 day and 93% had VA-ECMO terminated within 1 week. In multivariate analysis, the hazard ratio of 1-day support was significantly high at 1.72 (95% confidence intervals; 95% CI 1.53–1.95) (p < 0.001), while that of 2-day [0.60 (95% CI 0.49–0.73)], 3-day [0.75 (95% CI 0.60–0.94)], 4-day [0.43 (95% CI 0.31–0.60)] and 5-day support [0.62 (95% CI 0.44–0.86)] was significantly low. Comprehensive database analysis of JROAD-DPC revealed that cardiovascular patients who were supported with VA-ECMO for 2–5 days showed lower mortality. The optimal VA-ECMO support window should be investigated in further studies.
AB - Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been widely used for critically ill patients all over the world; however, comprehensive survey regarding the relationship between VA-ECMO duration and prognosis is limited. We conducted a survey of VA-ECMO patients in the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC), which was a health insurance claim database study among cardiovascular centers associated with the Japan Circulation Society, between April 2012 and March 2016. Out of 13,542 VA-ECMO patients, we analyzed 5766 cardiovascular patients treated with VA-ECMO. 68% patients used VA-ECMO only for 1 day and 93% had VA-ECMO terminated within 1 week. In multivariate analysis, the hazard ratio of 1-day support was significantly high at 1.72 (95% confidence intervals; 95% CI 1.53–1.95) (p < 0.001), while that of 2-day [0.60 (95% CI 0.49–0.73)], 3-day [0.75 (95% CI 0.60–0.94)], 4-day [0.43 (95% CI 0.31–0.60)] and 5-day support [0.62 (95% CI 0.44–0.86)] was significantly low. Comprehensive database analysis of JROAD-DPC revealed that cardiovascular patients who were supported with VA-ECMO for 2–5 days showed lower mortality. The optimal VA-ECMO support window should be investigated in further studies.
KW - Cardiovascular diseases
KW - Duration
KW - Extracorporeal membrane oxygenation
KW - Multicenter study
KW - Shock
UR - http://www.scopus.com/inward/record.url?scp=85139122784&partnerID=8YFLogxK
U2 - 10.1007/s00380-022-02158-0
DO - 10.1007/s00380-022-02158-0
M3 - 学術論文
C2 - 36173448
AN - SCOPUS:85139122784
SN - 0910-8327
VL - 38
SP - 228
EP - 235
JO - Heart and Vessels
JF - Heart and Vessels
IS - 2
ER -
