Neurologic Complications of Extracorporeal Membrane Oxygenation
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Background and Purpose Te rate and outcomes of neurologic complications of patients receiving extracorporeal membrane oxygenation (ECMO) are poorly understood. Te purpose of this study was to identify these parameters in ECMO patients. Methods All patients receiving ECMO were selected from the Nationwide Inpatient Sample between 2001–2011. Te rate and outcomes of neurologic complications [acute ischemic stroke, intracranial hemorrhage (ICH), and seizures] among these patients was determined. Discharge status, mortality, length of stay, and hospitalization costs were compared between patients with and without neurologic complications using chi-squared tests for categorical variables and Student’s t-test for continuous variables. Results In total, 23,951 patients were included in this study, of which 2,604 (10.9%) suffered neurologic complications of seizure (4.1%), stroke (4.1%), or ICH (3.6%). When compared to patients without neurologic complications, acute ischemic stroke patients had signifcantly higher rates of discharge to a long-term facility (12.2% vs. 6.8%, p<0.0001) and a signifcantly longer mean length of stay (41.6 days vs. 31.9 days, p<0.0001). ICH patients had signifcantly higher rates of discharge to a long-term facility (9.5% vs. 6.8%, p=0.007), signifcantly higher mortality rates (59.7% vs. 50.0%, p<0.0001), and a signifcantly longer mean length of stay (41.8 days vs. 31.9 days) compared to patients without neurologic complications. These outcomes did not differ significantly between seizure patients and patients without neurologic complications. Conclusions Given the increasing utilization of ECMO and the high costs and poor outcomes associated with neurologic complications, more research is needed to help determine the best way to prevent these sequelae in this patient population.
Abstract
Background and Purpose Te rate and outcomes of neurologic complications of patients receiving extracorporeal membrane oxygenation (ECMO) are poorly understood. Te purpose of this study was to identify these parameters in ECMO patients. Methods All patients receiving ECMO were selected from the Nationwide Inpatient Sample between 2001–2011. Te rate and outcomes of neurologic complications [acute ischemic stroke, intracranial hemorrhage (ICH), and seizures] among these patients was determined. Discharge status, mortality, length of stay, and hospitalization costs were compared between patients with and without neurologic complications using chi-squared tests for categorical variables and Student’s t-test for continuous variables. Results In total, 23,951 patients were included in this study, of which 2,604 (10.9%) suffered neurologic complications of seizure (4.1%), stroke (4.1%), or ICH (3.6%). When compared to patients without neurologic complications, acute ischemic stroke patients had signifcantly higher rates of discharge to a long-term facility (12.2% vs. 6.8%, p<0.0001) and a signifcantly longer mean length of stay (41.6 days vs. 31.9 days, p<0.0001). ICH patients had signifcantly higher rates of discharge to a long-term facility (9.5% vs. 6.8%, p=0.007), signifcantly higher mortality rates (59.7% vs. 50.0%, p<0.0001), and a signifcantly longer mean length of stay (41.8 days vs. 31.9 days) compared to patients without neurologic complications. These outcomes did not differ significantly between seizure patients and patients without neurologic complications. Conclusions Given the increasing utilization of ECMO and the high costs and poor outcomes associated with neurologic complications, more research is needed to help determine the best way to prevent these sequelae in this patient population.
참고문헌 (22)
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