Extracorporeal resuscitation as a further modifier of clinical outcome in patients with left ventricular assist device implantation and Interagency Registry for Mechanically Assisted Circulatory Support level 1. (12th February 2018)

• Record Type: Journal Article
• Authors: Ljajikj, Edis; Zittermann, Armin; Koster, Andreas; Börgermann, Jochen; Schönbrodt, Michael; Hakim-Meibodi, Kavous; Gummert, Jan; Morshuis, Michiel
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 27:Number 1(2018)
• Page Start: 139
• Page End: 141
• Publication Date: 2018-02-12
• Subjects: Extracorporeal life support -- Extracorporeal cardiopulmonary resuscitation -- Interagency Registry for Mechanically Assisted Circulatory Support level -- Left ventricular assist device; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivx433
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: In cardiogenic shock patients with Interagency Registry for Mechanical Circulatory Support (INTERMACS) level 1, the need for temporary circulatory support is a predictor and modifier of patient outcome. Because this group includes patients with and without cardiopulmonary resuscitation (CPR) and is thus very heterogeneous, we investigated whether a further subclassification is useful. We compared 30-day and 1-year mortality of patients who underwent left ventricular assist device implantation after extracorporeal CPR with the aid of an extracorporeal life support system (CPR+ group; n = 40) with cardiogenic shock patients in which the extracorporeal life support system was implanted under non-CPR conditions (CPR− group, n = 68). In the CPR+ and CPR− groups, 30-day mortality was 27.5% ( n = 11) and 8.8% ( n = 6), respectively ( P = 0.014). The values for 1-year mortality were 57.5% ( n = 23) and 36.8% ( n = 25), respectively ( P = 0.023). The age- and gender-adjusted hazard ratios of 30-day and 1-year mortality for the CPR+ group and the CPR− group were 3.88 (95% confidence interval 1.29–11.7; P = 0.016) and 1.79 (95% confidence interval 1.01–3.17; P = 0.045), respectively. In conclusion, our data show that left ventricular assist device implantation with extracorporeal life support following CPR is associated with high 30-day and 1-year mortality. Further multicentre studies are needed to confirm these results and potentially add CPR as a new modifier to the INTERMACS profile.