Association between Extracorporeal Membrane Oxygenation (ECMO) and Mortality in the Patients with Cardiac Arrest: A Nation-Wide Population-Based Study with Propensity Score Matched Analysis
- Authors
- Kim, Su Jin; Han, Kap Su; Lee, Eui Jung; Lee, Si Jin; Lee, Ji Sung; Lee, Sung Woo
- Issue Date
- 11월-2020
- Publisher
- MDPI
- Keywords
- cardiac arrest; extracorporeal membrane oxygenation; cardiopulmonary resuscitation; mortality; hospital cost; propensity-score matching
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.9, no.11
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 9
- Number
- 11
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/52025
- DOI
- 10.3390/jcm9113703
- ISSN
- 2077-0383
- Abstract
- We attempted to determine the impact of extracorporeal membrane oxygenation (ECMO) on short-term and long-term outcomes and find potential resource utilization differences between the ECMO and non-ECMO groups, using the National Health Insurance Service database. We selected adult patients (>= 20 years old) with non-traumatic cardiac arrest from 2007 to 2015. Data on age, sex, insurance status, hospital volume, residential area urbanization, and pre-existing diseases were extracted from the database. A total of 1.5% (n = 3859) of 253,806 patients were categorized into the ECMO group. The ECMO-supported patients were more likely to be younger, men, more covered by national health insurance, and showed, higher usage of tertiary level and large volume hospitals, and a lower rate of pre-existing comorbidities, compared to the non-ECMO group. After propensity score-matching demographic data, hospital factors, and pre-existing diseases, the odds ratio (ORs) of the ECMO group were 0.76 (confidence interval, (CI) 0.68-0.85) for 30-day mortality and 0.66 (CI 0.58-0.79) for 1-year mortality using logistic regression. The index hospitalization was longer, and the 30-day and 1-year hospital costs were greater in the matched ECMO group. Although ECMO support needed longer hospitalization days and higher hospital costs, the ECMO support reduced the risk of 30-day and 1-year mortality compared to the non-ECMO patients.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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