Validation of the ENCOURAGE mortality risk score in patients implanted by VA-ECMO for acute myocardial infarction with refractory cardiogenic shock - 26/03/18
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Résumé |
Introduction |
Although many risk models have been tested in patients implanted by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), few scores assessed VA-ECMO patient's prognosis in the setting of acute myocardial infarction (AMI) with refractory cardiogenic shock.
Objective |
The aim of this study was to investigate the ENCOURAGE score prediction value in patient implanted by VA-ECMO for AMI with refractory cardiogenic shock.
Method |
51 patients implanted by VA-ECMO for AMI with shock admitted in Tours University Hospital Intensive Cardiac Care Unit from March 2007 to March 2017 were retrospectively analysed.
Results |
The median age was 53 years, 80% were male. 32 patients (63%) survived at 30 days, and 28 patients (56%) at 6 months. 30 days after VA-ECMO implantation, probabilities of survival were 12, 17, 33, 66, 80% for ENCOURAGE score classes 0–12, 13–18, 19–22, 23–27, and≥28, respectively. The ENCOURAGE score ROC (area under curve AUC=0.83) was significantly better than those of the SAVE score, SOFA score and IGS2 score. The hazard ratio for survival at 30 days for each point of ENCOURAGE score was 1.10 (95% CI [1.06, 1.15]; P<0.001).
Conclusions |
Our data suggest that the ENCOURAGE score is valid to predict mortality at 30 days after VA-ECMO implantation for AMI with refractory cardiogenic shock. In addition of multidisciplinary clinical expertise, this score may help decision-making teams to better select AMI patients with shock for VA-ECMO implantation.
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Vol 10 - N° 2
P. 204-205 - avril 2018 Retour au numéro
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