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| Prognostic Factors of Extracorporeal Membrane Oxygenation in Elderly Patients with Cardiogenic Shock |
| LIU Jian-hong, YAN Hong-fang |
| Department of Cardiovascular Medicine,Hancheng people's hospital,Weinan Shaanxi 715401 |
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Abstract 【Objective】 To investigate the prognostic factors of extracorporeal membrane oxygenation (ECMO) in elderly patients with cardiogenic shock (CGS). 【Methods】 A total of 124 elderly patients with CGS treated in Hancheng people's Hospital and Yanliang Hospital of Xi'an Honghui hospital from January 2018 to February 2021 were treated with ECMO. The prognosis of patients 90 days after ECMO treatment was recorded and divided into survival group and death group. The influencing factors of ECMO treatment prognosis, the effects of SOFA score, blood lactic acid and cTnT on the prognosis of elderly CGS patients were analyzed, and the value of SOFA score, blood lactic acid and cTnT alone and in combination in predicting the prognosis was evaluated. 【Results】 The 90 day survival rate of 124 elderly patients with CGS after ECMO treatment was 75.81%, and the mortality was 24.19%. Univariate analysis showed that the age of death group>75 years old, the time from ICU to ECMO≥5 hours, acute renal injury, SOFA score, blood lactic acid and cTnT before ECMO treatment were higher than those in survival group, and LVEF before ECMO treatment was lower than those in survival group (P<0.05). Multivariate analysis showed that age, time from ICU to ECMO, acute renal injury, LVEF, SOFA score, blood lactic acid and cTnT before ECMO treatment were the influencing factors of the prognosis of elderly patients with CGS after ECMO treatment (P<0.05). Before ECMO treatment, the area under the curve (AUC) of SOFA score, blood lactic acid and cTnT to predict the prognosis of elderly CGS patients after ECMO treatment was > 0.7. The AUC predicted by the combination of various indexes was the largest, which was 0.947. The best prediction sensitivity and specificity were 86.67% and 90.43% respectively. 【Conclusion】 ECMO is effective in the treatment of elderly patients with CGS. The combination of SOFA score, blood lactic acid and cTnT before treatment is of high value in predicting the prognosis of patients.
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Received: 28 April 2021
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2022, Vol. 39 
