Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score
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...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2019-01-01
|
Series: | Critical Care |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s13054-019-2307-y |
id |
doaj-ce699c74c7cc4630b5a0f6cf36e8518b |
---|---|
record_format |
Article |
spelling |
doaj-ce699c74c7cc4630b5a0f6cf36e8518b2020-11-24T21:26:48ZengBMCCritical Care1364-85352019-01-0123111010.1186/s13054-019-2307-yPredicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER scoreLiangshan Wang0Feng Yang1Xiaomeng Wang2Haixiu Xie3Eddy Fan4Mark Ogino5Daniel Brodie6Hong Wang7Xiaotong Hou8Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical UniversityCenter for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical UniversityCenter for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical UniversityCenter for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical UniversityInterdepartmental Division of Critical Care Medicine, University of TorontoDivision of Neonatology, Nemours/Alfred I. DuPont Hospital for ChildrenColumbia University College of Physicians and Surgeons/New York-Presbyterian HospitalCenter for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical UniversityCenter for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical UniversityAbstract 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 < 100 × 109/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.http://link.springer.com/article/10.1186/s13054-019-2307-yCardiogenic shockVenoarterial extracorporeal membrane oxygenationCoronary artery bypass graftingpRedicting mortality in patients undergoing veno-arterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (REMEMBER) scoreMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Liangshan Wang Feng Yang Xiaomeng Wang Haixiu Xie Eddy Fan Mark Ogino Daniel Brodie Hong Wang Xiaotong Hou |
spellingShingle |
Liangshan Wang Feng Yang Xiaomeng Wang Haixiu Xie Eddy Fan Mark Ogino Daniel Brodie Hong Wang Xiaotong Hou Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score Critical Care 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 |
author_facet |
Liangshan Wang Feng Yang Xiaomeng Wang Haixiu Xie Eddy Fan Mark Ogino Daniel Brodie Hong Wang Xiaotong Hou |
author_sort |
Liangshan Wang |
title |
Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score |
title_short |
Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score |
title_full |
Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score |
title_fullStr |
Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score |
title_full_unstemmed |
Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score |
title_sort |
predicting mortality in patients undergoing va-ecmo after coronary artery bypass grafting: the remember score |
publisher |
BMC |
series |
Critical Care |
issn |
1364-8535 |
publishDate |
2019-01-01 |
description |
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 < 100 × 109/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. |
topic |
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 |
url |
http://link.springer.com/article/10.1186/s13054-019-2307-y |
work_keys_str_mv |
AT liangshanwang predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT fengyang predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT xiaomengwang predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT haixiuxie predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT eddyfan predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT markogino predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT danielbrodie predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT hongwang predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore AT xiaotonghou predictingmortalityinpatientsundergoingvaecmoaftercoronaryarterybypassgraftingtherememberscore |
_version_ |
1725977471700959232 |