Initial hospital length of stay and long-term survival of patients successfully resuscitated using extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest

Tamas Alexy, Rajat Kalra, Marinos Kosmopoulos, Jason A. Bartos, Andrea Elliott, Alejandra Gutierrez Bernal, Cindy M. Martin, Ranjit John, Andrew W. Shaffer, Ganesh Raveendran, Adamantios Tsangaris, Demetris Yannopoulos

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Aims The long-term outcomes of patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) for refractory ventricular tachycardia/ventricular fibrillation (VT/VF) out-of-hospital cardiac arrest (OHCA) remain poorly defined. The purpose of this study was to describe the hospital length of stay and long-term survival of patients who were successfully rescued with ECPR after refractory VT/VF OHCA. Methods and results In this retrospective cohort study, the length of index admission and long-term survival of patients treated with ECPR after OHCA at a single centre were evaluated. In a sensitivity analysis, survival of patients managed with left ventricular assist device (LVAD) implantation or heart transplantation during the same period was also evaluated. Between 1 January 2016 and 12 January 2020, 193 patients were transferred for ECPR considerations and 160 underwent peripheral veno-arterial extracorporeal membrane oxygenation cannulation. Of these, 54 (33.7%) survived the index admission. These survivors required a median 16 days of intensive care and 24 days total hospital stay. The median follow-up time of the survivors was 1216 (683, 1461) days. Of all, 79.6 and 72.2% were alive at 1 and 4 years, respectively. Most deaths within the first year occurred among the patients requiring discharge to a long-term acute care facility. Overall survival rates at 4 years were similar in the ECPR and LVAD cohorts (P = 0.30) but were significantly higher for transplant recipients (P < 0.001). Conclusion This data suggest that the lengthy index hospitalization required to manage OHCA patients with ECPR is rewarded by excellent long-term clinical outcomes in an expert ECPR programme.

Original languageEnglish (US)
Pages (from-to)175-183
Number of pages9
JournalEuropean Heart Journal: Acute Cardiovascular Care
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2023

Keywords

  • Extracorporeal cardiopulmonary resuscitation
  • Heart transplantation
  • Long-term survival
  • LVAD
  • Out-of-hospital cardiac arrest
  • VA-ECMO

ASJC Scopus subject areas

  • Medicine(all)

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