Liver function predicts survival in patients undergoing extracorporeal membrane oxygenation following cardiovascular surgery

Christian Roth, Lore Schrutka, Christina Binder, Lukas Kriechbaumer, Gottfried Heinz, Irene M Lang, Gerald Maurer, Herbert Koinig, Barbara Steinlechner, Alexander Niessner, Klaus Distelmaier, Georg Goliasch

Publikation: Beitrag in Fachzeitschrift (peer-reviewed)Artikel in Fachzeitschrift

46 Zitate (Scopus)

Abstract

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) represents a valuable and rapidly evolving therapeutic option in patients with severe heart or lung failure following cardiovascular surgery. However, despite significant advances in ECMO techniques and management, prognosis remains poor and accurate risk stratification challenging. We therefore evaluated the predictive value of liver function variables on all-cause mortality in patients undergoing venoarterial ECMO support after cardiovascular surgery.

METHODS: We included into our single-center registry a total of 240 patients undergoing venoarterial ECMO therapy following cardiovascular surgery at a university-affiliated tertiary care center.

RESULTS: The median follow-up was 37 months (interquartile range 19-67 months), and a total of 156 patients (65%) died. Alkaline phosphatase and total bilirubin were the strongest predictors for 30-day mortality, with adjusted hazard ratios (HRs) per 1-standard deviation increase of 1.36 (95% confidence interval [CI] 1.10-1.68; P = 0.004) and 1.22 (95% CI 1.07-1.40; P = 0.004), respectively. The observed associations persisted for long-term mortality, with adjusted HRs of 1.27 (95% CI 1.03-1.56; P = 0.023) for alkaline phosphatase and 1.22 (95% CI 1.07-1.39; P = 0.003) for total bilirubin.

CONCLUSIONS: The present study demonstrates that elevated values of alkaline phosphatase and total bilirubin are sensitive parameters for predicting the short-term and long-term outcomes of ECMO patients.

OriginalspracheEnglisch
Aufsatznummer57
Seiten (von - bis)57
FachzeitschriftCritical Care
Jahrgang20
Ausgabenummer1
DOIs
PublikationsstatusVeröffentlicht - 11 März 2016

ASJC Scopus Sachgebiete

  • Intensivmedizin

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