Age Differences in Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock: Trends in Application and Outcome From the Chinese Extracorporeal Life Support Registry.

Abstract

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly used for cardiogenic shock (CS) in adults, with age-influencing outcomes. Data from the Chinese Extracorporeal Life Support (CSECLS) Organization registry (January 2017-July 2023) were analyzed to assess in-hospital mortality in VA-ECMO for CS. Patients ≤65 years were categorized as young, and those >65 as elder. The primary outcome was in-hospital mortality, with secondary outcomes including ECMO weaning, 30 day survival, and complications. Of 5,127 patients, the young group (73.4%) had a median age of 51.0 (40.0-58.0) years, and the elder group (26.6%) had a median age of 71.0 (68.0-75.0) years. The in-hospital mortality was lower in the younger group (45.1%) compared with the elder group (52.6%, p < 0.001). The young group also had higher ECMO weaning rates (79.4% vs. 74.8%, p < 0.001) and 30 day survival (59.1% vs. 51.3%, p < 0.001). Bleeding, renal, and pulmonary complications were more frequent in young patients, though not statistically significant. Young patients undergoing VA-ECMO for CS generally have better outcomes than older patients, though careful selection is crucial to manage complications.