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Risk factor screening scale to optimize treatment for potential heart transplant candidates under extracorporeal membrane oxygenation
- Source :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 4(11)
- Publication Year :
- 2004
-
Abstract
- We developed a risk factor-scaling score (RFSS) to select which patients supported by extracorporeal membrane oxygenation (ECMO) were suitable for ventricular assist device (VAD) implantation or heart transplantation (HTx). A total of 78 patients supported with ECMO for more than 48 h due to cardiac origin were included in this study. Patients were categorized into two groups based on the outcomes: the poor outcome group (n = 33) consisted of for those who later died or were later excluded from VAD or HTx; the favorable outcome group (n = 45) consisted of those who were weaned off ECMO finally and survived or were deemed suitable candidates for VAD or HTx. Seven risk factors were significant according to univariate analyses. Based on the regression coefficients of multivariate analysis, the RFSS was developed: (lung dysfunction x 7) + (systemic infection x 3) + (peak lactate > 3 mmole/L x 3) + (kidney dysfunction x 2) + (creatine kinase > 10,000 U/L x 1). Patients with an RFSS of 7 or more were be allocated to the poor outcome group. The RFSS was validated by another group of 30 patients with good correlation. The RFSS provides a way to predict which ECMO-supported patients are suitable candidates for VAD implantation or HTx.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Blood Urea Nitrogen
Extracorporeal Membrane Oxygenation
Risk Factors
Internal medicine
medicine
Extracorporeal membrane oxygenation
Immunology and Allergy
Humans
Pharmacology (medical)
Treatment Failure
Risk factor
Survival analysis
Aged
Probability
Heart transplantation
Transplantation
Univariate analysis
business.industry
Reproducibility of Results
Middle Aged
medicine.disease
Survival Analysis
Blood Cell Count
Treatment Outcome
Ventricular assist device
Heart failure
Cardiology
Heart Transplantation
Female
Heart-Assist Devices
business
Ventilator Weaning
Blood Chemical Analysis
Subjects
Details
- ISSN :
- 16006135
- Volume :
- 4
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Accession number :
- edsair.doi.dedup.....44566bec630afc4a657f698bf1759309