التفاصيل البيبلوغرافية
| العنوان: |
The ENCOURAGE mortality risk score and analysis of long-term outcomes after VA-ECMO for acute myocardial infarction with cardiogenic shock. |
| المؤلفون: |
Muller, Grégoire1, Flecher, Erwan2, Lebreton, Guillaume3, Luyt, Charles-Edouard1, Trouillet, Jean-Louis1, Bréchot, Nicolas1, Schmidt, Matthieu1, Mastroianni, Ciro3, Chastre, Jean1, Leprince, Pascal3, Anselmi, Amedeo2, Combes, Alain1 alain.combes@aphp.fr |
| المصدر: |
Intensive Care Medicine. Mar2016, Vol. 42 Issue 3, p370-378. 9p. 3 Charts, 2 Graphs. |
| مصطلحات موضوعية: |
*HEALTH outcome assessment, *OXYGENATION (Chemistry), *MYOCARDIAL infarction treatment, *QUALITY of life, *ANXIETY, *CARDIOGENIC shock, *COMPARATIVE studies, *MENTAL depression, *EXTRACORPOREAL membrane oxygenation, *INTENSIVE care units, *RESEARCH methodology, *MEDICAL cooperation, *POST-traumatic stress disorder, *QUESTIONNAIRES, *RESEARCH, *RISK assessment, *EVALUATION research, *PREDICTIVE tests, *GLASGOW Coma Scale, *THERAPEUTICS, MORTALITY risk factors, MYOCARDIAL infarction-related mortality |
| مصطلحات جغرافية: |
FRANCE |
| مستخلص: |
Purpose: This study was designed to identify factors associated with in-intensive care unit (ICU) death and develop a practical mortality risk score for venoarterial-extracorporeal membrane oxygenation (VA-ECMO)-treated acute myocardial infarction (AMI) patients. Long-term survivors' health-related quality of life (HRQOL), anxiety, depression, and post-traumatic stress disorder (PTSD) frequencies were also assessed.Methods: Data from 138 ECMO-treated AMI patients admitted to two French ICUs (2008-2013) were analyzed. ICU survivors contacted >6 months post-ICU discharge were assessed for HRQOL, psychological and PTSD status.Results: Sixty-five patients (47%) survived to ICU discharge. On the basis of multivariable logistic regression analyses, the ENCOURAGE score was constructed with seven pre-ECMO parameters: age >60, female sex, body mass index >25 kg/m(2), Glasgow coma score <6, creatinine >150 μmol/L, lactate (<2, 2-8, or >8 mmol/L), and prothrombin activity <50%. Six months after ECMO, probabilities of survival were 80, 58, 25, 20, and 7% for ENCOURAGE score classes 0-12, 13-18, 19-22, 23-27, and ≥28, respectively. The ENCOURAGE score ROC AUC [0.84 (95% CI 0.77-0.91)] was significantly better than those of the SAVE, SAPS II, and SOFA scores. Survivors' HRQOL evaluated after median follow-up of 32 months revealed satisfactory mental health but persistent physical and emotional-related difficulties, with 34% (95% CI 20-49%) anxiety, 20% (95% CI 8-32%) depression, and 5% (95% CI 0-12%) PTSD symptoms reported.Conclusions: The ENCOURAGE score might be a useful tool to predict mortality of severe cardiogenic shock AMI patients who received VA-ECMO. However, it now needs prospective validation on other populations of AMI patients. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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