Ary Serpa Neto, Alisa M Higgins, Michael J Bailey, Shannah Anderson, Stephen Bernard, Bentley J Fulcher, Annalie Jones, Natalie J Linke, Jasmin V Board, Daniel Brodie, Heidi Buhr, Aidan J C Burrell, D James Cooper, Eddy Fan, John F Fraser, David J Gattas, Ingrid K Hopper, Sue Huckson, Edward Litton, Shay P McGuinness, Priya Nair, Neil Orford, Rachael L Parke, Vincent A Pellegrino, David V Pilcher, Craig Dicker, Benjamin A J Reddi, Dion Stub, Tony V Trapani, Andrew A Udy, Carol L Hodgson
{"title":"成人VA-ECMO术后前12个月的远期功能结局：一项前瞻性多中心研究","authors":"Ary Serpa Neto, Alisa M Higgins, Michael J Bailey, Shannah Anderson, Stephen Bernard, Bentley J Fulcher, Annalie Jones, Natalie J Linke, Jasmin V Board, Daniel Brodie, Heidi Buhr, Aidan J C Burrell, D James Cooper, Eddy Fan, John F Fraser, David J Gattas, Ingrid K Hopper, Sue Huckson, Edward Litton, Shay P McGuinness, Priya Nair, Neil Orford, Rachael L Parke, Vincent A Pellegrino, David V Pilcher, Craig Dicker, Benjamin A J Reddi, Dion Stub, Tony V Trapani, Andrew A Udy, Carol L Hodgson","doi":"10.1161/CIRCHEARTFAILURE.124.012476","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Long-term outcomes and quality of life have been identified as core patient-centered outcomes for venoarterial extracorporeal membrane oxygenation (VA-ECMO) research. The aim of this study is to investigate the incidence of death or new disability at 12 months after the initiation of VA-ECMO.</p><p><strong>Methods: </strong>Prospective, multicenter, registry-embedded cohort study in 26 hospitals in Australia and New Zealand from February 2019 through April 2023. Adult patients admitted to a participating ICU and who underwent VA-ECMO were included. The primary outcome was death or new disability at 6 and 12 months. All results were adjusted for patient characteristics at the time of ECMO initiation.</p><p><strong>Results: </strong>Among 389 patients who received VA-ECMO (median age, 57 [44-65] years; 35% women), the incidence of death or new disability at 12 months was 70.6% compared with 70.8% at 6 months (adjusted odds ratio for 12 versus 6 months, 0.61 [95% CI, 0.25-1.49]; <i>P</i>=0.27). Compared with 6 months, at 12 months after VA-ECMO more patients were independent in activities of daily living (62.1% versus 48.2%; adjusted odds ratio, 2.84 [95% CI, 1.50-5.36]; <i>P</i>=0.001), and fewer patients were unemployed due to health reasons (32.7% versus 47.4%; adjusted odds ratio, 0.29 [95% CI, 0.13-0.65]; <i>P</i><0.001). Differences in outcomes were found according to the reason for VA-ECMO initiation.</p><p><strong>Conclusions: </strong>At 12 months after VA-ECMO, 30% of patients are alive and without disability, with differences in outcome associated with the reason for VA-ECMO initiation. The major burden of disability appears to develop in the first 6 months after VA-ECMO initiation and is sustained between 6 and 12 months.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03793257.</p>","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e012476"},"PeriodicalIF":8.4000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-Term Functional Outcomes in the First 12 Months After VA-ECMO in Adult Patients: A Prospective, Multicenter Study.\",\"authors\":\"Ary Serpa Neto, Alisa M Higgins, Michael J Bailey, Shannah Anderson, Stephen Bernard, Bentley J Fulcher, Annalie Jones, Natalie J Linke, Jasmin V Board, Daniel Brodie, Heidi Buhr, Aidan J C Burrell, D James Cooper, Eddy Fan, John F Fraser, David J Gattas, Ingrid K Hopper, Sue Huckson, Edward Litton, Shay P McGuinness, Priya Nair, Neil Orford, Rachael L Parke, Vincent A Pellegrino, David V Pilcher, Craig Dicker, Benjamin A J Reddi, Dion Stub, Tony V Trapani, Andrew A Udy, Carol L Hodgson\",\"doi\":\"10.1161/CIRCHEARTFAILURE.124.012476\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Long-term outcomes and quality of life have been identified as core patient-centered outcomes for venoarterial extracorporeal membrane oxygenation (VA-ECMO) research. The aim of this study is to investigate the incidence of death or new disability at 12 months after the initiation of VA-ECMO.</p><p><strong>Methods: </strong>Prospective, multicenter, registry-embedded cohort study in 26 hospitals in Australia and New Zealand from February 2019 through April 2023. Adult patients admitted to a participating ICU and who underwent VA-ECMO were included. The primary outcome was death or new disability at 6 and 12 months. All results were adjusted for patient characteristics at the time of ECMO initiation.</p><p><strong>Results: </strong>Among 389 patients who received VA-ECMO (median age, 57 [44-65] years; 35% women), the incidence of death or new disability at 12 months was 70.6% compared with 70.8% at 6 months (adjusted odds ratio for 12 versus 6 months, 0.61 [95% CI, 0.25-1.49]; <i>P</i>=0.27). Compared with 6 months, at 12 months after VA-ECMO more patients were independent in activities of daily living (62.1% versus 48.2%; adjusted odds ratio, 2.84 [95% CI, 1.50-5.36]; <i>P</i>=0.001), and fewer patients were unemployed due to health reasons (32.7% versus 47.4%; adjusted odds ratio, 0.29 [95% CI, 0.13-0.65]; <i>P</i><0.001). Differences in outcomes were found according to the reason for VA-ECMO initiation.</p><p><strong>Conclusions: </strong>At 12 months after VA-ECMO, 30% of patients are alive and without disability, with differences in outcome associated with the reason for VA-ECMO initiation. The major burden of disability appears to develop in the first 6 months after VA-ECMO initiation and is sustained between 6 and 12 months.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03793257.</p>\",\"PeriodicalId\":10196,\"journal\":{\"name\":\"Circulation: Heart Failure\",\"volume\":\" \",\"pages\":\"e012476\"},\"PeriodicalIF\":8.4000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Circulation: Heart Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012476\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Circulation: Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.012476","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/29 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Long-Term Functional Outcomes in the First 12 Months After VA-ECMO in Adult Patients: A Prospective, Multicenter Study.
Background: Long-term outcomes and quality of life have been identified as core patient-centered outcomes for venoarterial extracorporeal membrane oxygenation (VA-ECMO) research. The aim of this study is to investigate the incidence of death or new disability at 12 months after the initiation of VA-ECMO.
Methods: Prospective, multicenter, registry-embedded cohort study in 26 hospitals in Australia and New Zealand from February 2019 through April 2023. Adult patients admitted to a participating ICU and who underwent VA-ECMO were included. The primary outcome was death or new disability at 6 and 12 months. All results were adjusted for patient characteristics at the time of ECMO initiation.
Results: Among 389 patients who received VA-ECMO (median age, 57 [44-65] years; 35% women), the incidence of death or new disability at 12 months was 70.6% compared with 70.8% at 6 months (adjusted odds ratio for 12 versus 6 months, 0.61 [95% CI, 0.25-1.49]; P=0.27). Compared with 6 months, at 12 months after VA-ECMO more patients were independent in activities of daily living (62.1% versus 48.2%; adjusted odds ratio, 2.84 [95% CI, 1.50-5.36]; P=0.001), and fewer patients were unemployed due to health reasons (32.7% versus 47.4%; adjusted odds ratio, 0.29 [95% CI, 0.13-0.65]; P<0.001). Differences in outcomes were found according to the reason for VA-ECMO initiation.
Conclusions: At 12 months after VA-ECMO, 30% of patients are alive and without disability, with differences in outcome associated with the reason for VA-ECMO initiation. The major burden of disability appears to develop in the first 6 months after VA-ECMO initiation and is sustained between 6 and 12 months.
期刊介绍：
Circulation: Heart Failure focuses on content related to heart failure, mechanical circulatory support, and heart transplant science and medicine. It considers studies conducted in humans or analyses of human data, as well as preclinical studies with direct clinical correlation or relevance. While primarily a clinical journal, it may publish novel basic and preclinical studies that significantly advance the field of heart failure.
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