D-22 | Impact of Age on ECMO related outcomes in Hospitalized Patients

The use of ECMO for hemodynamic (HD) support is becoming increasingly prevalent. While potentially life-saving, ECMO use has its complications. We aim to assess the safety of ECMO use for older population through this retrospective analysis. The national readmission database (2016-2020) was utilized to identify hospitalizations requiring ECMO. Cohorts were stratified based by age. A Propensity Score Matching (PSM) model matched young (age <65) & older (age ≥65) patients. Pearson's x2 test was applied to PSM-2 matched cohorts to compare outcomes. Among 40,984 hospitalizations requiring ECMO; About 29.2% (N: 11,991) patients were in older age group. After propensity matching (N: 5,993), older patients had higher mortality (34.03% vs 25.35%, aOR:1.33, p<0.001), acute myocardial infarction (MI) (23% vs 14.4%, aOR:1.53, p<0.001), post-procedural bleeding (6.7% vs 5.3%, aOR:1.19, p:0.001), transfusion requirement (25.5% vs 21.9%, aOR: 1.26, p<0.001) & MACE risk (aOR:1.30, p<0.001). From 2016-2020: Mortality has increased significantly in both age groups. In younger patients, mortality has increased from 3.6% in 2016 to 35.6% in 2020 (p-trend<0.01); In older group, mortality has increased from 7% in 2016 to 43.1% in 2020 (p-trend: <0.001). Younger patients on the other hand, were more likely to be readmitted at 90-day (24.4% vs 20.5%, p<0.001) & 180-day (28% vs 24.5%, p:0.003). Older patients placed on ECMO have higher mortality & post-procedural bleeding even on propensity-matched cohort. A worrisome up-trend has been noticed in mortality rates in both age groups in recent years.