Table 3.
Univariate and Multivariate Cox Model Analysis of Pre-cECMO In-Hospital Mortality-Associated factors
| Variables | Univariate | Multivariate | ||
|---|---|---|---|---|
| HR (95% CI) | p-value | HR (95% CI) | p-value | |
| Female | 0.78 [0.45 to 1.34] | 0.4 | ||
| Age, years | 1.01 [0.99 to 1.03] | 0.2 | ||
| Body mass index, kg/m2 | 1.04 [1.00 to 1.09] | 0.07 | ||
| Study period | ||||
| 2006–2009 | — | |||
| 2010–2013 | 1.59 [0.68 to 3.72] | 0.3 | ||
| 2014–2017 | 1.02 [0.54 to 1.93] | 0.9 | ||
| 2018–2021 | 1.20 [0.52 to 2.80] | 0.7 | ||
| 2022–2023 | 0.82 [0.25 to 2.73] | 0.7 | ||
| ICU admission SAPS II score | 1.01 [1.00 to 1.03] | 0.1 | ||
| ICU admission SOFA score | 1.04 [0.98 to 1.10] | 0.2 | ||
| Charlson comorbidity index | 1.18 [0.94 to 1.48] | 0.1 | ||
| Past medical history | ||||
| Arterial hypertension | 1.16 [0.61 to 2.19] | 0.6 | ||
| Cardiomyopathy | 1.00 [0.53 to 1.90] | 0.9 | ||
| Diabetes | 1.32 [0.52 to 3.31] | 0.6 | ||
| Immunocompromised | 0.82 [0.33 to 2.06] | 0.7 | ||
| Cause of the cardiogenic shock | ||||
| Myocarditis | — | |||
| Myocardial infarction | 2.38 [1.25 to 4.54] | 0.008 | 2.50 [1.26 to 4.95] | 0.009 |
| Dilated cardiomyopathy | 1.38 [0.66 to 2.86] | 0.4 | 1.61 [0.75 to 3.43] | 0.2 |
| Othersa | 0.38 [0.09 to 1.67] | 0.2 | 0.29 [0.04 to 2.26] | 0.2 |
| First MCS | ||||
| Cardiac arrest before first MCS | 1.01 [0.57 to 1.77] | 0.9 | ||
| IMPELLA® | 1.30 [0.56 to 3.05] | 0.5 | ||
| Intraaortic conterpulsation | 1.50 [0.89 to 2.53] | 0.1 | ||
| Organ failures before cECMO | ||||
| Renal replacement therapy | 1.87 [1.09 to 3.19] | 0.02 | 1.34 [0.58 to 3.10] | 0.5 |
| Mechanical ventilation > 48 h | 1.23 [0.68 to 2.23] | 0.5 | ||
| Time on MV, days | 0.99 [0.98 to 1.00] | 0.05 | ||
| cECMO configuration | ||||
| ≤ 3 cannulas | — | |||
| 4 cannulas | 0.94 [0.54 to 1.64] | 0.8 | ||
| Reason for cECMO switch | ||||
| > 1 reason | 1.02 [0.61 to 1.72] | 0.9 | ||
| Pulmonary edema | 0.99 [0.58 to 1.69] | 0.9 | ||
| Circulatory failure | 1.00 [0.58 to 1.73] | > 0.99 | ||
| Cannulation site infection | 1.00 [0.52 to 1.94] | > 0.99 | ||
| Lower limb ischemia | 1.80 [0.65 to 4.99] | 0.3 | ||
| Cardiac cavities pre-thrombotic state | 1.24 [0.64 to 2.39] | 0.5 | ||
| cECMO-day parameters | ||||
| SOFA score | 1.10 [1.01 to 1.20] | 0.03 | 1.04 [0.91 to 1.19] | 0.5 |
| Platelets, G/L | 1.00 [0.99 to 1.00] | 0.6 | ||
| Fibrinogen, g/L | 0.89 [0.77 to 1.02] | 0.08 | ||
| Prothrombin time, % | 0.99 [0.97 to 1.00] | 0.09 | ||
| Bilirubin, UI/L | 1.00 [1.00 to 1.00] | 0.9 | ||
Abbreviations: HR: Hazard Ratio; CI: Confidence Interval; BIVAD: Bi Ventricular Assist Device; cECMO: central Extracorporeal Membrane Oxygenation; ICU: Intensive Care Unit; MCS: Mechanical Circulatory Support; MV: Mechanical Ventilation: SAPS-II: simplified acute physiology score II; SOFA: Sequential Organ Failure Assessment
aOthers: hypertrophic cardiomyopathies n = 2, catastrophic antiphospholipid syndrome n = 1, anaphylactic shock n = 1, arrhythmic storm n = 1, iatrogenic rupture of tricuspid papillary muscle n = 1 and cardiogenic shock of unknown aetiology n = 1