Outcomes with use of extra-corporeal membrane oxygenation in high-risk pulmonary embolism: a national database perspective.
Mohamed Farhan NasserAhmad JabriShorabh SharmaLaith AlhuneafatYazan Abu OmarVidya KrishnanScott J CameronPublished in: Journal of thrombosis and thrombolysis (2023)
High-risk pulmonary embolism (PE) patients can be managed with systemic lysis, catheter-based therapies, or surgical embolectomy. Despite the advent of newer therapies, patients with high-risk PE remain with a 50-60% short-term mortality risk. In such patients, extracorporeal membrane oxygenation (ECMO) is increasingly utilized for hemodynamic support. To evaluate the outcomes of the use of ECMO in patients with high-risk PE. Using the National Inpatient Sample (NIS) database, we identified patients with high-risk PE using ICD 10 codes and compared in-hospital outcomes of patients with and without ECMO support. We identified 38,035 patients with high-risk PE, of whom 820 had undergone ECMO placement. Most patients who underwent ECMO were male (54%), white (65%), and with a mean age of 53.7 years. ECMO use was not associated with a meaningful difference in patient mortality when comparing treatment groups (OR, 1.32 ± 0.39; 0.74-2.35; p = 0.35). Rather, ECMO use was associated with a higher frequency of inpatient complications. ECMO use was not associated with a significant difference in patient mortality in patients with high-risk PE.
Keyphrases
- extracorporeal membrane oxygenation
- pulmonary embolism
- acute respiratory distress syndrome
- end stage renal disease
- respiratory failure
- ejection fraction
- newly diagnosed
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- type diabetes
- healthcare
- mental health
- inferior vena cava
- intensive care unit
- mechanical ventilation
- adipose tissue
- emergency department
- cardiovascular disease
- patient reported outcomes
- skeletal muscle
- adverse drug
- coronary artery disease
- ultrasound guided
- electronic health record
- combination therapy