Risk Factors for the Mortality of Patients With Coronavirus Disease 2019Requiring Extracorporeal Membrane Oxygenation in a Non-Centralized Setting: A Nationwide Study
- Author:
Tae Wan KIM
1
;
Won-Young KIM
;
Sunghoon PARK
;
Su Hwan LEE
;
Onyu PARK
;
Taehwa KIM
;
Hye Ju YEO
;
Jin Ho JANG
;
Woo Hyun CHO
;
Jin-Won HUH
;
Sang-Min LEE
;
Chi Ryang CHUNG
;
Jongmin LEE
;
Jung Soo KIM
;
Sung Yoon LIM
;
Ae-Rin BAEK
;
Jung-Wan YOO
;
Ho Cheol KIM
;
Eun Young CHOI
;
Chul PARK
;
Tae-Ok KIM
;
Do Sik MOON
;
Song-I LEE
;
Jae Young MOON
;
Sun Jung KWON
;
Gil Myeong SEONG
;
Won Jai JUNG
;
Moon Seong BAEK
;
Author Information
- Publication Type:Original Article
- From:Journal of Korean Medical Science 2024;39(8):e75-
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Background:Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO.
Methods:We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method.
Results:Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004).
Conclusion:Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.
