TABLE 4.
Comprehensive Multivariable Model of Factors Associated With Mortality in Patients Using Extracorporeal Membrane Oxygenation After Failure to Wean From Cardiopulmonary Bypass
| Variables | OR (95% CI) | p |
|---|---|---|
| Demographic and baseline clinical characteristics | ||
| Age (d) | < 0.001 | |
| ≤ 7 | 1.0 (reference group) | — |
| > 7 and ≤ 26 | 0.802 (0.601–1.069) | 0.132 |
| > 26 and ≤ 159 | 0.558 (0.416–0.750) | < 0.001 |
| > 159 | 0.478 (0.346–0.661) | < 0.001 |
| Genetic syndrome or congenital anomalies | 1.776 (1.358–2.324) | < 0.001 |
| Comorbidities | 1.586 (1.297–1.941) | < 0.001 |
| Pre-ECMO cardiac arrest | 1.675 (1.200–2.338) | 0.002 |
| Surgery details | ||
| Cardiopulmonary bypass time (min) | < 0.001 | |
| ≤ 174 | 1 (reference group) | — |
| > 174 and ≤ 251 | 0.967 (0.730–1.281) | 0.816 |
| > 251 and ≤ 351 | 1.501 (1.132–1.990) | 0.005 |
| > 351 | 1.609 (1.209–2.142) | 0.001 |
| RACHS-1 category | 0.004 | |
| RACHS 1–3 | 1 (reference group) | — |
| RACHS 4–6 | 1.435 (1.133–1.816) | 0.003 |
| RACHS not assigned | 0.745 (0.451–1.231) | 0.251 |
| Pre-ECMO details | ||
| Pre-ECMO mechanical ventilation duration > 24 hr | 1.494 (1.211–1.843) | < 0.001 |
| Pre-ECMO bicarbonate infusion | 1.419 (1.084–1.857) | 0.011 |
| ECMO factors | ||
| ECMO support duration (hr) | < 0.001 | |
| ≤ 65 | 1 (reference group) | — |
| > 65 and ≤ 104 | 0.765 (0.581–1.009) | 0.057 |
| > 104 and ≤ 169 | 1.539 (1.173–2.018) | 0.002 |
| > 169 | 3.472 (2.557–4.715) | < 0.001 |
| Complications | ||
| ECMO circuit complications | 1.259 (1.018–1.558) | 0.034 |
| CNS complications | 1.793 (1.358–2.366) | < 0.001 |
| Pulmonary hemorrhage | 2.527 (1.672–3.819) | < 0.001 |
| Renal failure | 1.698 (1.232–2.341) | 0.001 |
| Hemofiltration required | 1.540 (1.224–1.939) | < 0.001 |
ECMO = extracorporeal membrane oxygenation, OR = odds ratio, RACHS = Risk Adjustment in Congenital Heart Surgery.
Model: Candidate variables: age, race (White), genetic syndrome or congenital anomalies, comorbidities, pre-ECMO cardiac arrest, cardiopulmonary bypass time, RACHS-1 category, pre-ECMO mechanical ventilation duration > 24 hr, pre-ECMO bicarbonate infusion, left atrium cannulation, ECMO pump flow at 4 hr, ECMO support duration, Fio2 at 24 hr after ECMO initiation, ECMO circuit complications, CNS complications, pulmonary hemorrhage, renal failure, and hemofiltration required.
n = 2,024; p = 0.538 for Hosmer-Lemeshow test; area under the curve = 0.769.
− refers that no p value is calculable for that group because it is a reference group. It is a common sign for the reference group if there are multiple categories.