Risk factors for poor prognosis in patients with extracorporeal cardiopulmonary resuscitation
Objective To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation(ECPR),and to explore the risk factors leading to poor prognosis.Methods The clinical data of 95 patients with ECPR admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2023 were retrospectively analyzed.According to the survival status at the time of discharge,the patients were divided into the survival group and death group.The difference of clinical data between the two groups was compared to explore the risk factors related to death and poor prognosis.Risk factors associated with death were identified by Binary Logistic regression analysis.Results A total of 95 patients with ECPR were included in this study,62(65.3％)died and 33(34.7％)survived at discharge.Patients in the death group had longer low blood flow time[40(30,52.5)min vs.30(24.5,40)min]and total cardiac arrest time[40(30,52.5)min vs.30(24.5,40)min],shorter total hospital stay[3(2,7.25)d vs.19(13.5,31)d]and extracorporeal membrane oxygenation(ECMO)assisted time[26.5(17,50)h vs.62(44,80.5)h],and more IHCA patients(56.5％vs.33.3％)and less had spontaneous rhythm recovery before ECMO(37.1％vs.84.8％).Initial lactate value[(14.008±5.188)mmol/L vs.(11.23±4.718)mmol/L],APACHE Ⅱ score[(30.10±7.45)vs.(25.88±7.68)]and SOFA score[12(10.75,16)vs.10(9.5,13)]were higher(P＜0.05).Conclusions No spontaneous rhythm recovery before ECMO,high initial lactic acid and high SOFA score are independent risk factors for poor prognosis in ECPR patients.
万方数据
维普
