Definitions of major bleeding for predicting mortality in critically ill adult patients who survived 24 hours while supported with peripheral veno-arterial extracorporeal membrane oxygenation for cardiogenic shock: a comparative historical cohort study
Authors' conclusion
Extracorporeal Life Support Organization-serious bleeding and BARC ≥ type 2 are relevant definitions of major bleeding regarding their association with mortality in critically ill patients who survived the first 24 hr while supported with pVA-ECMO for cardiogenic shock.
Study context
- Population
- Consecutive adults on peripheral VA-ECMO for refractory cardiogenic shock who survived 24 hr, Lille academic hospitals, January 2013 to December 2019
- Participants
- 308 adults
- Exposure
- Three major bleeding definitions for predicting 28-day mortality
- Outcome
- All-cause mortality
- Follow-up
- 28 days
Methodological detailscomparative historical cohort, consecutive patients, multivariate models accounting for time-dependent and competing variables
- Comparative historical cohort
- Consecutive patients
- Multivariate models accounting for time-dependent and competing variables
Main finding
As reported in the abstract
Association of bleeding definitions with 28-day all-cause mortality
Extracorporeal Life Support Organization (ELSO)-serious bleeding
0.69
95% CI 0.63 to 0.74
Harrell's C-index
Bleeding Academic Research Consortium (BARC)
0.69
95% CI 0.63 to 0.74
Harrell's C-index
Hazard ratio (95% CI)
ELSO-serious bleeding
1.67(1.09–2.56)
BARC ≥ type 2
1.55(1.01–2.37)
- 28-day mortality, all patients
- 128/308 (42%)
Observational data: associations, not effects.
Further findings
Predictors of ELSO-serious bleeding
- Postcardiotomy, BMI, baseline platelet count, fibrinogen and hemoglobin levels
Original publication
Definitions of major bleeding for predicting mortality in critically ill adult patients who survived 24 hours while supported with peripheral veno-arterial extracorporeal membrane oxygenation for cardiogenic shock: a comparative historical cohort study. Can J Anaesth. Published 4 March 2024. doi:10.
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