Table 1.
Characteristics of OHCA patients who underwent ECPR for medical causes
| All (n = 1660) | WLST (n = 510) | no WLST (n = 1150) | p-value | |
|---|---|---|---|---|
| Baseline characteristics | ||||
| Male gender, n (%) | 1382/1660 (83.2) | 427/510 (83.7) | 965/1150 (83.9) | 0.279 |
| Age, median [IQR] | 61 [50–69] | 62 [51–70] | 61 [49–68] | 0.032 |
| Cardiac arrest location | 0.079 | |||
| Home, n (%) | 674/1660 (40.6) | 226/510 (44.3) | 448/1150 (38.9) | |
| Public, n (%) | 693/1660 (41.7) | 193/510 (37.8) | 500/1150 (43.4) | |
| Other, n (%) | 293/1660 (17.6) | 91/510 (17.8) | 202/1150 (17.5) | |
| PS before admission | 0.107 | |||
| PS 0, n (%) | 1462/1621 (90.1) | 441/494 (89.2) | 1021/1127 (90.5) | |
| PS 1, n (%) | 127/1621 (7.8) | 37/494 (7.4) | 90/1127 (7.9) | |
| PS 2, n (%) | 21/1621 (1.3) | 11/494 (2.2) | 10/1127 (0.8) | |
| PS 3, n (%) | 11/1621 (0.6) | 5/494 (1.0) | 6/1127 (0.5) | |
| PS 4, n (%) | 0/1621 (0) | 0/494 (0) | 0/1127 (0) | |
| Initial rhythm | ||||
| VF/VT, n (%) | 1071/1646 (65.0) | 318/503 (63.2) | 753/1143 (65.8) | 0.297 |
| PEA/asystole, n (%) | 575/1646 (34.9) | 185/503 (36.7) | 390/,1143 (34.1) | 0.297 |
| Presumed cardiac origin, n (%) | 1358/1648 (82.4) | 403/505 (79.8) | 955/1143 (83.5) | 0.065 |
| Presumed cause of cardiac arrest | ||||
| Acute coronary syndrome, n (%) | 924/1639 (56.3) | 274/502 (54.5) | 650/1137 (57.1) | 0.330 |
| Arrhythmia, n (%) | 232/1639 (14.1) | 62/502 (12.3) | 170/1137 (14.9) | 0.164 |
| Pulmonary embolism, n (%) | 52/1639 (3.1) | 20/502 (3.9) | 32/1137 (2.8) | 0.213 |
| Aortic dissection, n (%) | 92/1639 (5.6) | 18/502 (3.5) | 74/1137 (6.5) | 0.018 |
| Primary cerebral disorders n (%) | 50/1639 (3.0) | 32/502 (6.3) | 18/1137 (1.5) | < 0.001 |
| Other, n (%) | 289/1639 (17.6) | 96/502 (19.1) | 193/1137 (16.9) | 0.031 |
| Witnessed collapse, n (%) | 1295/1652 (78.3) | 407/506 (80.4) | 888/1146 (77.4) | 0.180 |
| Bystander CPR, n (%) | 949/1633 (58.1) | 290/500 (58.0) | 659/,1133 (58.1) | 0.951 |
| ECPR | ||||
| Time interval (min), median [IQR] | ||||
| EMS arrival-ECMO pump on | 41 [28–49] | 41 [27–48] | 41 [28–49] | 0.242 |
| IABP use, n (%) | 1018/1656 (61.4) | 300/510 (58.8) | 718/1146 (62.6) | 0.139 |
| ECMO-related complications, n (%) | 410/1660 (24.7) | 125/510 (24.5) | 285/1150 (24.7) | 0.905 |
| Procedure‑related complications, n (%) | 256/1653 (15.4) | 75/505 (14.8) | 206/1148 (15.7) | 0.653 |
| Brain ischemia, n (%) | 6/1660 (0.3) | 2/510 (0.3) | 4/1150 (0.3) | 0.890 |
| Mesenteric ischemia, n (%) | 9/1654 (0.5) | 3/505 (0.5) | 6/1149 (0.5) | 0.855 |
| Cerebral hemorrhage, n (%) | 16/1644 (0.9) | 8/510 (1.5) | 8/1150 (0.7) | 0.093 |
| Gastrointestinal bleeding, n (%) | 35/1654 (2.1) | 19/508 (3.7) | 16/1146 (1.4) | 0.002 |
| Other hemorrhagic complication, n (%) | 101/1654 (6.1) | 28/508 (5.5) | 73/1146 (6.3) | 0.829 |
| ECMO mechanical complication, n (%) | 27/1628 (1.6) | 11/500 (2.2) | 16/1128 (1.4) | 0.255 |
| ICU data and treatments | ||||
| Blood gas pH (ICU admission), median [IQR] | 7.30 [7.20–7.39] | 7.30 [7.19–7.40] | 7.30 [7.20–7.38] | 0.848 |
| Serum lactate (mmol/L), median [IQR] | 7.8 [5.3–11.6] | 8.4 [5.7–12.0] | 7.6 [5.0–11.3] | 0.008 |
| SOFA score, median [IQR] | 12 [8–13] | 12 [8–13] | 12 [9–13] | 0.460 |
| Pupil diameter ≥ 4 mm on ICU admission, n (%) | 398/1233 (32.2) | 138/420 (32.8) | 260/813 (31.9) | 0.755 |
| Pupil diameter ≥ 6 mm on ICU admission, n (%) | 132/1233 (10.7) | 57/420 (13.5) | 75/813 (9.2) | 0.019 |
| Sepsis, n (%) | 135/1368 (9.8) | 43/457 (9.4) | 92/911 (10.1) | 0.687 |
| Septic shock, n (%) | 87/1363 (6.3) | 35/457 (7.6) | 52/906 (5.7) | 0.171 |
| Acute renal failure, n (%) | 553/1349 (40.9) | 218/455 (47.9) | 335/894 (37.4) | < 0.001 |
| Ventilator-associated pneumonia, n (%) | 162/1342 (12.0) | 45/449 (10.0) | 117/893 (13.1) | 0.102 |
| Vasopressor use, n (%) | 629/1362 (46.1) | 192/454 (42.2) | 437/908 (48.1) | 0.042 |
| Renal replacement therapy, n (%) | 236/1357 (17.3) | 69/453 (15.2) | 167/904 (18.4) | 0.137 |
| Tracheostomy, n (%) | 245/1642 (14.9) | 52/505 (10.3) | 193/1137 (16.9) | < 0.001 |
| Temperature management, n (%) | ||||
| 32 °C-below 36 °C | 828/1112 (74.4) | 237/328 (72.2) | 591/784 (75.3) | 0.276 |
| 36 °C or higher | 284/1112 (25.5) | 91/328 (27.7) | 193/784 (24.6) | 0.276 |
| Temperature management canceled, n (%) | 324/1095 (29.5) | 106/322 (32.9) | 218/773 (28.2) | 0.119 |
CPR Cardiopulmonary resuscitation, ECMO Extracorporeal membrane oxygenation, ECPR Extracorporeal cardiopulmonary resuscitation, EMS Emergency medical service, IABP Intra-aortic balloon pump, ICU Intensive care unit, IQR Interquartile range, SOFA Sequential organ failure assessment, OHCA Out-of-hospital cardiac arrest, PEA Pulseless electrical activity, PS Performance status, VF Ventricular fibrillation, VT Ventricular tachycardia, WLST Withholding/withdrawal of life-sustaining therapy