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Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis

Introduction: The effectiveness of extracorporeal membrane oxygenation (ECMO) in treating COVID-19 patients has been variable. To gain a better insight, we examined the outcomes of ECMO in COVID-19 patients using data from the 2020 National Inpatient Sample database. Methods: We analyzed data from a...

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Autores principales: Ahmad, Rami, Abrahamian, Andrew, Salih, Ayman, Patel, Rayna, Holtzapple, Zachary, Assaly, Ragheb, Safi, Fadi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532225/
https://www.ncbi.nlm.nih.gov/pubmed/37762954
http://dx.doi.org/10.3390/jcm12186013
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author Ahmad, Rami
Abrahamian, Andrew
Salih, Ayman
Patel, Rayna
Holtzapple, Zachary
Assaly, Ragheb
Safi, Fadi
author_facet Ahmad, Rami
Abrahamian, Andrew
Salih, Ayman
Patel, Rayna
Holtzapple, Zachary
Assaly, Ragheb
Safi, Fadi
author_sort Ahmad, Rami
collection PubMed
description Introduction: The effectiveness of extracorporeal membrane oxygenation (ECMO) in treating COVID-19 patients has been variable. To gain a better insight, we examined the outcomes of ECMO in COVID-19 patients using data from the 2020 National Inpatient Sample database. Methods: We analyzed data from adult hospital admissions where COVID-19 was the primary diagnosis. The primary outcome was all-cause inpatient mortality. Secondary outcomes were length of stay (LOS), cost, and discharge disposition. Results: We identified 1,048,025 COVID-19 admissions, of which 98,528 were on mechanical ventilation (MV), and only 1.8% received ECMO. In-hospital mortality of mechanically ventilated patients who received ECMO was 49%, compared to 59% with no ECMO (p < 0.001). ECMO treatment was associated with a reduced risk of mortality (HR = 0.67, p < 0.0001, CI 0.57–0.79) even after adjustment for confounders and other comorbidities. Patients on ECMO had significantly extended hospital stays and were more likely to be discharged to an acute care facility. Younger and male patients were more likely to receive ECMO treatment. Females had a lower mortality risk, while race and obesity were not associated with an increased risk of death. Conclusion: ECMO treatment may offer survival benefits in severe COVID-19. Based on our findings, we suggest early ECMO treatment for patients with a high mortality risk.
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spelling pubmed-105322252023-09-28 Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis Ahmad, Rami Abrahamian, Andrew Salih, Ayman Patel, Rayna Holtzapple, Zachary Assaly, Ragheb Safi, Fadi J Clin Med Article Introduction: The effectiveness of extracorporeal membrane oxygenation (ECMO) in treating COVID-19 patients has been variable. To gain a better insight, we examined the outcomes of ECMO in COVID-19 patients using data from the 2020 National Inpatient Sample database. Methods: We analyzed data from adult hospital admissions where COVID-19 was the primary diagnosis. The primary outcome was all-cause inpatient mortality. Secondary outcomes were length of stay (LOS), cost, and discharge disposition. Results: We identified 1,048,025 COVID-19 admissions, of which 98,528 were on mechanical ventilation (MV), and only 1.8% received ECMO. In-hospital mortality of mechanically ventilated patients who received ECMO was 49%, compared to 59% with no ECMO (p < 0.001). ECMO treatment was associated with a reduced risk of mortality (HR = 0.67, p < 0.0001, CI 0.57–0.79) even after adjustment for confounders and other comorbidities. Patients on ECMO had significantly extended hospital stays and were more likely to be discharged to an acute care facility. Younger and male patients were more likely to receive ECMO treatment. Females had a lower mortality risk, while race and obesity were not associated with an increased risk of death. Conclusion: ECMO treatment may offer survival benefits in severe COVID-19. Based on our findings, we suggest early ECMO treatment for patients with a high mortality risk. MDPI 2023-09-16 /pmc/articles/PMC10532225/ /pubmed/37762954 http://dx.doi.org/10.3390/jcm12186013 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ahmad, Rami
Abrahamian, Andrew
Salih, Ayman
Patel, Rayna
Holtzapple, Zachary
Assaly, Ragheb
Safi, Fadi
Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis
title Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis
title_full Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis
title_fullStr Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis
title_full_unstemmed Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis
title_short Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis
title_sort demographics and outcomes of extracorporeal membrane oxygenation in covid-19 patients: national database analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10532225/
https://www.ncbi.nlm.nih.gov/pubmed/37762954
http://dx.doi.org/10.3390/jcm12186013
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