Background: Venoarterial extracorporeal membrane oxygenation (VA ECMO) has been used to provide mechanical circulatory support in refractory cardiogenic shock. Prognostic factors associated with poor outcomes vary between studies. Methods: We searched PubMed and Embase databases from 1 January 1969 to 17 November 2025 for studies investigating prognostic factors and short-term survival in patients with cardiogenic shock receiving VA ECMO. The primary analysis was presented as adjusted odds ratios (aOR). Generic inverse variance random-effects meta-analyses were performed. We assessed the quality of included studies using the QUIPS tool and certainty of evidence using the GRADE approach. Results: The primary analysis of adjusted variables included 13 studies and 8,505 patients. We found that renal replacement therapy (aOR: 2.92, 95%-CI: 1.05–8.12, p=0.04) and serum lactate pre or at VA ECMO initiation (aOR: 1.26, 95%-CI: 1.16–1.37, p<0.0001) were significantly associated with mortality, while there was no association between gender or ECMO duration with mortality. With our secondary analysis, serum lactate (unadjusted OR: 1.48, 95%-CI: 1.26–1.74, p<0.0001) and comorbidities including chronic kidney disease (OR: 3.33, 95%-CI: 1.46-7.59, p=0.004) and diabetes mellitus (OR: 1.78, 95%-CI: 1.08–2.92, p=0.023) were associated with short-term mortality. Conclusion: We identified prognostic factors associated with mortality in critically ill patients receiving VA ECMO for cardiogenic shock. These findings have implications for risk stratification.
Lim et al. (Mon,) studied this question.