Trends in mortality and resource utilization for extracorporeal membrane oxygenation in the United States: 2008–2014

Sanaiha, Yas; Bailey, Kate; Downey, Peter; Seo, Young-Ji; Aguayo, Esteban; Dobaria, Vishal; Shemin, Richard J.; Benharash, Peyman

doi:10.1016/j.surg.2018.08.012

Cited by 61 publications

(64 citation statements)

References 33 publications

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“…The expansion of ECLS in both trauma and nontrauma settings is undeniable, but it has not been uniform. There is considerable geographic variability in the utilization of ECMO, as well as heterogeneity among hospitals, with urban‐teaching institutions accounting for the majority of ECMO use 14 . Given this distribution, we hypothesized that trauma outcomes may differ based on a trauma center's access to ECMO.…”

Section: Discussionmentioning

confidence: 99%

Access to extracorporeal life support as a quality metric: Lessons from trauma

et al. 2020

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Background Access to centers with extracorporeal membrane oxygenation (ECMO) capabilities varies by region and may affect overall outcomes. We assessed the outcomes of trauma patients requiring ECMO support and compared the overall survival of all patients with trauma at facilities with and without ECMO capabilities. Methods A retrospective review of the National Trauma Data Bank was performed to identify all trauma patients receiving care at ECMO and non‐ECMO centers. Baseline patient characteristics and outcomes were analyzed. Adjusted odds ratio (OR) was used to compare survival at ECMO and non‐ECMO facilities. Results Between 2007 and 2015, a total of 5 781 123 patients with trauma were identified with 1 983 986 (34%) admitted to an ECMO facility and 3 797 137 (66%) admitted to a non‐ECMO facility. A total of 522 (0.03%) patients required ECMO. Both the number of patients with trauma requiring ECMO support and the number of trauma facilities utilizing ECMO increased over the 9‐year‐study period (4.9 to 13.8 patients per 100 000 admissions, and 18 to 77 centers, respectively). The mortality for ECMO patients was 40.5%. Patients with trauma admitted to ECMO facilities had more severe injuries (injury severity score: 9.0 vs 8.0; P < .001). The overall mortality was 3.3%. The adjusted OR for mortality associated with admission to an ECMO facility vs a non‐ECMO facility was 0.96 (95% confidence interval: 0.95‐0.97; adjusted P < .001). Conclusions The use of ECMO for patients with trauma is expanding. Our study demonstrates a survival benefit associated with admission to a facility with ECMO capabilities. Thus, access to ECMO is a potential quality metric for trauma centers.

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Section: Discussionmentioning

confidence: 99%

Access to extracorporeal life support as a quality metric: Lessons from trauma

et al. 2020

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“…27,28 Between 2008 and 2014 in the United States, the most common indications were respiratory failure (n = 8,062 cases) and postcardiotomy (n = 6,583 cases). 29 Extracorporeal membrane oxygenation for respiratory failure should be considered in cases when mortality is 50% or greater and is indicated when mortality is 80% or greater. Indications are summarized in Table 7.…”

Section: Ecmo For Pulmonary Failurementioning

confidence: 99%

Extracorporeal Membrane Oxygenation: The New Jack-of-All-Trades?

Kwak

Majewski

Jellish

2020

Journal of Cardiothoracic and Vascular Anesthesia

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“…In the United States, ECMO utilization is increasing rapidly, particularly in the Northeast region. 10 Between 2008 and 2014, ECMO admissions in the United States increased 369%, numbering 4,825 admissions in 2014. 10 Worldwide, in-hospital costs of ECMO ranged from $42,554 to 537,554 in 2013.…”

mentioning

confidence: 99%

“…10 Between 2008 and 2014, ECMO admissions in the United States increased 369%, numbering 4,825 admissions in 2014. 10 Worldwide, in-hospital costs of ECMO ranged from $42,554 to 537,554 in 2013. 11 The global cost of ECMO care is significant, and improved prognostication may allow for better resource allocation and minimization of futile care.…”

mentioning

confidence: 99%