Comparison of Four Intensive Care Scores in Predicting Outcomes After Venoarterial Extracorporeal Membrane Oxygenation: A Single-center Retrospective Study
Authors' conclusion
The APACHE-II, SOFA, and CASUS, calculated at 24 hours of ICU admission, were significantly higher among nonsurvivors compared with survivors. The APACHE-II demonstrated the highest mortality predictive ability.
Study context
- Population
- Patients admitted to the cardiothoracic intensive care units (ICU) for ≥24 hours after venoarterial extracorporeal membrane oxygenation (VA-ECMO) insertion, tertiary care center, 2015–2022
- Participants
- 142 patients
- Exposure
- Acute Physiology and Chronic Health Evaluation II (APACHE-II) vs Sequential Organ Failure Assessment (SOFA) vs Cardiac Surgery Score (CASUS) vs Survival After VA-ECMO (SAVE) scores for predicting mortality
- Outcome
- Predictive ability of the scores for mortality
Methodological detailsobservational, single-centre
- Observational
- Single-centre
Main finding
As reported in the abstract
Mortality prediction (ROC analysis)
| Group | AUC (APACHE-II >27) |
|---|---|
| APACHE-II | 0.66 |
APACHE-II
AUC (APACHE-II >27)0.66
Observational data: associations, not effects.
Further findings
Scores in nonsurvivors vs survivors · 24 hours of ICU admission
- APACHE-II, SOFA and CASUS significantly higher among nonsurvivors
Clinical factors associated with mortality
- Pre-ECMO serum lactate and creatinine significantly associated with mortality
- Lower ECMO flow rates at 4 and 12 hours post-cannulation significantly correlated with survival to discharge
- Arrhythmias, AKI and need for CRRT on ECMO significantly associated with mortality
Original publication
Comparison of Four Intensive Care Scores in Predicting Outcomes After Venoarterial Extracorporeal Membrane Oxygenation: A Single-center Retrospective Study. J Cardiothorac Vasc Anesth. Published 22 October 2024. doi:10.
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