Table 2.
Baseline, cardiac arrest times, ECMO run and outcome characteristics of ECPR patients, in-hospital versus out-of-hospital cardiac arrest
| Characteristics | Total (n = 199) | In-hospital (n = 104) | Out of hospital (n = 95) | P-value |
|---|---|---|---|---|
| Age, yr, mean (SD) | 50.5 (15.2) | 52.6 (16.0) | 48.2 (14.1) | 0.02 |
| Female, n (%) | 48 (24.1) | 33 (31.7) | 15 (15.8) | 0.009 |
| Comorbidities, n (%) | ||||
| Diabetes type 1 or 2 | 33 (16.6) | 23 (22.1) | 10 (10.5) | 0.028 |
| Chronic kidney disease CKD 1–3 | 9 (4.5) | 9 (8.7) | 0 (0) | 0.003 |
| Heart failure (NYHA 1 or 2) | 8 (4.0) | 6 (5.7) | 2 (2.1) | 0.19 |
| Peripheral vascular disease | 5 (2.5) | 4 (3.8) | 1(1.0) | 0.21 |
| Ischaemic heart disease (prior to admission) | 29 (14.6) | 21 (20.2) | 8 (8.4) | 0.019 |
| Cardiac intervention prior (PCI, CABG, other) | 40 (20.1) | 34 (32.7) | 6 (6.3) | < 0.001 |
| COPD (Stage 3 or less) | 5 (2.5) | 4 (3.9) | 1 (1.0) | 0.21 |
| Chronic liver disease (Child–Pugh A or less) | 3 (1.5) | 1 (1.0) | 2 (2.1) | 0.53 |
| Cardiac arrest and ECMO run | ||||
| CPR in progress at ECMO initiation, n (%) | 187 (94) | 98 (94.2) | 89 (93.7) | 0.87 |
| Shockable initial rhythm, n (%) | 103 (53.7) | 35 (35.7) | 68 (72.3) | < 0.001 |
| Any ROSC, n (%) | 86 (43.2) | 46 (44.2) | 40 (42.1) | 0.76 |
| Bystander CPR performed, n (%) | 191 (96.0) | 104 (100) | 87 (91.6) | 0.003 |
| Witnessed arrest, n (%) | 185 (93.0) | 100 (96.2) | 85 (89.5) | 0.066 |
| Duration of cardiac arrest* at arrival of ECMO provider, min, median, (IQR) | 30 (8–51) | 10 (5–25) | 50 (43–66) | < 0.001 |
| Time for decision, set up, cannulation, min, median, (IQR) | 22 (16–35) | 21 (13–35) | 25 (20–34) | 0.022 |
| Total time to ECMO support, min, median, (IQR) | 59 (35–82) | 39 (24–53) | 77 (68–95) | < 0.001 |
| Outcome | ||||
| Coronary angiogram performed, n (%) | 120 (60.3) | 53 (51.0) | 67 (70.5) | 0.005 |
| Cardiac therapeutic intervention, n (%) | ||||
| Percutaneous coronary intervention** review | 65 (32.7) | 26 (25.0) | 39 (41.1) | 0.016 |
| Cardiac bypass surgery | 13 (6.5) | 10 (9.6) | 3 (3.1) | 0.066 |
| AICD | 13 (6.5) | 9 (8.67 | 4 (4.2) | 0.21 |
| Other | 26 (13.1) | 17 (16.4) | 9 (9.5) | 0.15 |
| ECMO weaned sucessfully, n (%) | 88 (44.2) | 63 (60.6) | 25 (26.3) | < 0.001 |
| ECMO duration (weaned), d, median (IQR) | 4 (2–7) | 5 (2–8) | 4 (2–6) | 0.54 |
| Bridge to LVAD, n (%) | 5 (2.5) | 4 (3.9) | 1 (1.0) | 0.21 |
| Bridge to heart transplant, n (%) | 4 (2.0) | 1 (1.0) | 3 (3.2) | 0.27 |
| Survival to hospital discharge, n (%) | 62 (31.2) | 43 (41.4) | 19 (20.0) | 0.001 |
| CPC of survivors at discharge, total n = 62, n (%) | ||||
| 1 | 51 (82.2) | 38 (88.4) | 13 (68.4) | |
| 2 | 9 (14.5) | 5 (11.6) | 4 (21.1) | |
| 3 | 1 (1.6) | 0 (0) | 1 (5.3) | |
| 4 | 0 (0) | 0 (0) | 0 (0) | |
| Uncertain CPC | 1 (1.6) | 0 (0) | 1 (5.3) | |
| Organ donation, n (%) | 14 (7.0) | 3 (2.9) | 11 (11.6) | 0.017 |
*cardiac arrest time refers to the longest arrest time with or without ROSC < 20 min
SD Standard deviation, IQR Interquartile range, CKD Chronic kidney disease, NYHA New York Heart Association, PCI Percutaneous coronary intervention, CABG Coronary artery bypass grafting, COPD Chronic obstructive pulmonary disease, ROSC Return of spontaneous circulation, CPR Cardiopulmonary resuscitation, ECMO Extracorporeal membrane oxygenation, LVAD Left ventricular assist device, AICD Automated internal cardiac defibrillator, CPC Cerebral performance category