초록접수 현황
| 16F-291 | 포럼 발표 |
Inter-Facility Transport on Extracorporeal Life Support: Clinical Outcomes and Comparative Analysis with In-house Patients
Tae Hee Hong, Heemoon Lee, Yang Hyun Cho, Kiick Sung, Ji-Hyuk Yang, Young Tak Lee
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
Background : Extracorporeal life support (ECLS) is widely used in refractory heart or lung failure and the demand of inter-facility transportation on ECLS is expanding. However, little has been known about post-transportation outcome, its clinical safety and characteristics of transported patients.
Methods : This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transports as well as a comparative analysis of clinical outcome with in-house ECLS adult patients. We also analyzed risk factors for hospital mortality of entire ECLS population using univariate and multivariate analysis to investigate the effect of transport adjusted by other variables.
Results : There were 44 adults in transported group and 173 adults in in-house group. All 44 patients (100%) were safely transported without adverse event. The average travel distance was 178.7 km (ranged 13 to 500 km) with average travel time of 74.0 min (ranged 15 to 180 min). Early survival of transported group seemed to be better than that of in-house group, but the difference was not statistically significant(70.5% vs 56.6%, p=0.096). In the subgroup of veno-veno ECLS, there was a significant difference in early survival between transported and in-house patients (81.3% vs. 40.5%, p=0.006). The incidence of complications were similar between two groups, except for critical limb ischemia which was significantly higher in transported group than in in-house group (25.0% vs 8.1%, p=0.017). After adjusting confounders, transported group was not a predictor of early death (adjusted OR=0.658, p=0.346).
Conclusion : Transportation on ECLS is relatively safe, and the clinical outcome regarding transported patients on ECLS is acceptable and comparable with in-house ECLS patients. Critical limb ischemia might more frequently develop in transported patients than in-house veno-arteiral ECLS patients. Although matched studies or prospective studies are required, our study demonstrated transportation of patients on ECLS does not increase risk of hospital mortality even after adjustment of other risk factors
Methods : This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transports as well as a comparative analysis of clinical outcome with in-house ECLS adult patients. We also analyzed risk factors for hospital mortality of entire ECLS population using univariate and multivariate analysis to investigate the effect of transport adjusted by other variables.
Results : There were 44 adults in transported group and 173 adults in in-house group. All 44 patients (100%) were safely transported without adverse event. The average travel distance was 178.7 km (ranged 13 to 500 km) with average travel time of 74.0 min (ranged 15 to 180 min). Early survival of transported group seemed to be better than that of in-house group, but the difference was not statistically significant(70.5% vs 56.6%, p=0.096). In the subgroup of veno-veno ECLS, there was a significant difference in early survival between transported and in-house patients (81.3% vs. 40.5%, p=0.006). The incidence of complications were similar between two groups, except for critical limb ischemia which was significantly higher in transported group than in in-house group (25.0% vs 8.1%, p=0.017). After adjusting confounders, transported group was not a predictor of early death (adjusted OR=0.658, p=0.346).
Conclusion : Transportation on ECLS is relatively safe, and the clinical outcome regarding transported patients on ECLS is acceptable and comparable with in-house ECLS patients. Critical limb ischemia might more frequently develop in transported patients than in-house veno-arteiral ECLS patients. Although matched studies or prospective studies are required, our study demonstrated transportation of patients on ECLS does not increase risk of hospital mortality even after adjustment of other risk factors
첨부파일 : Table, Figure.docx
책임저자: Yang Hyun Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Tae Hee Hong, E-mail : taehee888@naver.com