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.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: