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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| Format: | Article |
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MDPI AG
2023-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/18/6013 |
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| author | Rami Ahmad Andrew Abrahamian Ayman Salih Rayna Patel Zachary Holtzapple Ragheb Assaly Fadi Safi |
| author_facet | Rami Ahmad Andrew Abrahamian Ayman Salih Rayna Patel Zachary Holtzapple Ragheb Assaly Fadi Safi |
| author_sort | Rami Ahmad |
| collection | DOAJ |
| 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 (<i>p</i> < 0.001). ECMO treatment was associated with a reduced risk of mortality (HR = 0.67, <i>p</i> < 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. |
| first_indexed | 2024-03-10T22:37:42Z |
| format | Article |
| id | doaj.art-e10a492b5fa847688f6ae44c4f4a4441 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T22:37:42Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-e10a492b5fa847688f6ae44c4f4a44412023-11-19T11:20:35ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011218601310.3390/jcm12186013Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database AnalysisRami Ahmad0Andrew Abrahamian1Ayman Salih2Rayna Patel3Zachary Holtzapple4Ragheb Assaly5Fadi Safi6Department of Internal Medicine, University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, University of Toledo, Toledo, OH 43606, USADepartment of Internal Medicine, University of Toledo, Toledo, OH 43606, USAIntroduction: 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 (<i>p</i> < 0.001). ECMO treatment was associated with a reduced risk of mortality (HR = 0.67, <i>p</i> < 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.https://www.mdpi.com/2077-0383/12/18/6013COVID-19extracorporeal membrane oxygenationmortalityhospital staynational inpatient sample |
| spellingShingle | Rami Ahmad Andrew Abrahamian Ayman Salih Rayna Patel Zachary Holtzapple Ragheb Assaly Fadi Safi Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis Journal of Clinical Medicine COVID-19 extracorporeal membrane oxygenation mortality hospital stay national inpatient sample |
| 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 | COVID-19 extracorporeal membrane oxygenation mortality hospital stay national inpatient sample |
| url | https://www.mdpi.com/2077-0383/12/18/6013 |
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