Epidemiology of ischemic stroke and hemorrhagic stroke in venoarterial extracorporeal membrane oxygenation
Authors' conclusion
In V-A ECMO patients between 2012 and 2021, 90-day mortality decreased, while ischemic stroke incidence increased. ELSO centers with higher annual case volumes had lower mortality, but were not associated with ischemic/hemorrhagic stroke incidence. Both ischemic/hemorrhagic strokes were associated with increased mortality.
Study context
- Population
- Adult V-A ECMO patients, Extracorporeal Life Support Organization (ELSO) registry, 534 international centres, 2012–2021, excluding ECPR20,297 with mortality data
- Participants
- 33,041 patients
- Outcome
- Trends and associations of ischemic/hemorrhagic stroke incidence and mortality, and their risk factors, including annual centre case volume
- Follow-up
- 90-day mortality
Methodological detailsmulticentre registry, temporal trend analysis, multivariable regression, survival analysis
- Multicentre registry
- Temporal trend analysis
- Multivariable regression
- Survival analysis
Main finding
As reported in the abstract
- Ischemic stroke incidence increased 2012–2021
- p < 0.0001
- Overall 90-day mortality declined 2012–2021
- p < 0.0001
- Ischemic/hemorrhagic strokes associated with increased 90-day mortality (both)
- p < 0.0001
- Higher annual case volume associated with lower 90-day mortality
- p = 0.001
Observational data: associations, not effects.
Further findings
Hazard of death over time
- Hazard of death highest in the first several days of V-A ECMO
Original publication
Epidemiology of ischemic stroke and hemorrhagic stroke in venoarterial extracorporeal membrane oxygenation. Crit Care. Published 9 November 2023. doi:10.
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