초록접수 현황
| 14F-021 | 구연 발표 |
The SAPS II to Predict Outcome on Extracorporeal Membrane Oxygenation for Patients with Acute Circulatory and/or Respiratory Failure at Emergency Department: A Retrospective Study
Hyoung-Soo Kim, Kun-Il Kim, Hee-Sung Lee, Won-Yong Lee, Sung-Woo Cho, Sun-Hee Lee
Department of Thoracic and Cardiovascular Surgery, Hallym University College of Medicine
Background : The aim of this study was to investigate factors that can predict the outcome of using extracorporeal membrane oxygenation (ECMO) in patients with acute circulatory and/or respiratory failure, who do not respond to conventional treatment in the emergency department (ED).
Methods : This was a retrospective review of the medical records of 65 patients who were treated with ECMO in the ED due to acute circulatory and/or respiratory failure unresponsive to conventional therapy, between January 2009 and December 2013.
Results : Of the 65 patients, 52 were men and the median patient age was 56 years. A total of 49 patients were placed on venoarterial mode, 10 were on venovenous mode, and 6 were subjected to change ECMO modes in depending on their condition. The median door-to-ECMO time was 93 minutes and the 28-day survival rate was 48%. In univariate and multivariate analysis that evaluated independent factors contributing to mortality, only the Simplified Acute Physiology Score II (SAPS II) showed statistical significance (odds ratio, 1.148; 95% confidence interval [CI], 1.037–1.271; p = 0.008). The area under the receiver operating characteristic curve with respect to the SAPS II was 0.852 (95% CI, 0.753–0.951, p < 0.01). At a SAPS II cut-off value of 81, the sensitivity and 1-specificity were 0.971 and 0.290, respectively. The 60-month cumulative survival rate for patients with a SAPS II < 81 was 82%, whereas the rate for patients with a SAPS II ≥ 81 was 23% (p < 0.01).
Conclusion : Based on our results, the survival rate could be improved by using of ECMO in patients with a pre-ECMO SAPS II < 81, who had unresponsive acute circulatory and/or respiratory failure in the ED.
Methods : This was a retrospective review of the medical records of 65 patients who were treated with ECMO in the ED due to acute circulatory and/or respiratory failure unresponsive to conventional therapy, between January 2009 and December 2013.
Results : Of the 65 patients, 52 were men and the median patient age was 56 years. A total of 49 patients were placed on venoarterial mode, 10 were on venovenous mode, and 6 were subjected to change ECMO modes in depending on their condition. The median door-to-ECMO time was 93 minutes and the 28-day survival rate was 48%. In univariate and multivariate analysis that evaluated independent factors contributing to mortality, only the Simplified Acute Physiology Score II (SAPS II) showed statistical significance (odds ratio, 1.148; 95% confidence interval [CI], 1.037–1.271; p = 0.008). The area under the receiver operating characteristic curve with respect to the SAPS II was 0.852 (95% CI, 0.753–0.951, p < 0.01). At a SAPS II cut-off value of 81, the sensitivity and 1-specificity were 0.971 and 0.290, respectively. The 60-month cumulative survival rate for patients with a SAPS II < 81 was 82%, whereas the rate for patients with a SAPS II ≥ 81 was 23% (p < 0.01).
Conclusion : Based on our results, the survival rate could be improved by using of ECMO in patients with a pre-ECMO SAPS II < 81, who had unresponsive acute circulatory and/or respiratory failure in the ED.
책임저자: 김형수
한림대학교 의과대학 흉부외과학교실
연락처 : Hyoung-Soo Kim, Tel: 033-240-5366 , E-mail : cskhs99@hallym.or.kr
