Predictive value of blood inflammatory biomarkers for mortality risk in ECMO-supported patients following cardiac surgery
10.3760/cma.j.cn112434-20250421-00124
- VernacularTitle:血液炎性标志物对心外科术后ECMO支持患者死亡风险的预测研究
- Author:
Tingting WU
1
;
Yiwen WANG
;
Yan WANG
;
Xiaotong HOU
;
Zhe DONG
Author Information
1. 首都医科大学附属北京安贞医院心外危重症中心 北京市心肺血管疾病研究所，北京 100029
- Publication Type:Journal Article
- Keywords:
Procalcitonin;
C-reactive protein;
Extracorporeal membrane oxygenation;
Systemic inflammatory response syndrome;
Lactic acid
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(7):421-426
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the dynamic changes of inflammatory biomarkers in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) support after cardiac surgery, and evaluate their predictive value for in-hospital mortality.Methods:The retrospective study included 212 patients who underwent VA-ECMO support following cardiac surgery at Beijing Anzhen Hospital, Capital Medical University, from January 2021 to May 2024. Baseline characteristics and inflammatory markers during ECMO support including procalcitonin (PCT), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and fibrinogen (FBG) were collected. Univariate analysis, ROC curves, and multivariate logistic regression were performed to assess the association of these indicators with outcomes. Results:On day 3 post-ECMO, mean PCT and CRP levels were significantly higher in the deceased group (87 cases) than in the survival group (125 cases). PCT demonstrated an area under the curve ( AUC) of 0.750 (95% CI: 0.680-0.819) for predicting mortality, while CRP had an AUC of 0.701(95% CI: 0.625-0.778). No significant differences were observed in FBG, NLR, or PLR between the two groups. Lactate levels at 24 h post-ECMO ( AUC=0.723) and SOFA scores ( OR=2.511, AUC=0.713) were also significantly associated with mortality risk in the deceased group ( P<0.05). Conclusion:Dynamic increases in PCT and CRP are independent predictors of in-hospital mortality in cardiac surgery patients supported by ECMO. Elevated lactate levels and SOFA scores, aligning with previous studies, reflect severe tissue hypoperfusion and multi-organ dysfunction in non-survivors, underscoring the necessity of dynamic monitoring of inflammatory and organ function markers for prognosis assessment.
