D-5 | Deciphering the Impact of ECMO in Unstable Pulmonary Embolism: A Critical Outcomes Analysis

Extracorporeal Membrane Oxygenation (ECMO) in critical care cardiology has increased, yet its clinical outcomes in pulmonary embolism (PE) remain partially understood. This study scrutinizes the in -hospital outcomes of ECMO in patients with unstable PE. Utilizing data from the National Readmission Database from 2016 to 2020, we identified patients presenting with unstable PE, dividing them based on ECMO treatment. Multivariate regression analysis was employed to evaluate ECMO's impact on primary (in-hospital mortality) and secondary outcomes (readmission rates and complications). Table I shows baseline characteristics, and Table II shows the outcome. In patients with pulmonary embolism (PE), those receiving Extracorporeal Membrane Oxygenation (ECMO) showed higher in-hospital mortality (45% vs. 5%, p < 0.0000) and acute kidney injury (AKI) (69.4% vs. 22%, p < 0.000) compared to non-ECMO patients. ECMO treatment resulted in longer hospital stays (22 vs. 5 days, p < 0.000) and higher hospitalization costs. The 30-day readmission rate was lower in ECMO patients (2.9% vs. 7%, p < 0.0000). Major predictors of readmission and mortality included age, AKI, and LOS. ECMO use in unstable PE is associated with higher in-hospital mortality, increased complications, particularly AKI, and a longer LOS, albeit with a lower readmission rate likely due to the high mortality rate in the index admission. This study underscores the need for careful patient selection and highlights the risk factors that may influence outcomes in ECMO-managed PE patients.