What question did this study set out to answer?

This research aims to identify factors predicting mortality in cardiogenic shock patients supported by VA-ECMO.

February 6, 2026

Predictors of mortality in patients with cardiogenic shock and veno-arterial extracorporeal membrane oxygenation

Key Points

This research aims to identify factors predicting mortality in cardiogenic shock patients supported by VA-ECMO.
Retrospective analysis of 195 adult patients receiving VA-ECMO for refractory cardiogenic shock from 2016 to 2023.
Assessment of clinical outcomes including survival rates and associated factors.
Statistical analysis using multivariable logistic regression to identify independent predictors.
51.8% of patients died on VA-ECMO, while 30.3% survived to hospital discharge.
Non-survivors exhibited higher rates of chronic kidney disease and atrial fibrillation compared to survivors.
Initial SOFA score, blood lactate at 24 hours, and atrial fibrillation emerged as significant mortality predictors.

Abstract

Abstract Background Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a life-saving procedure for patients with refractory cardiogenic shock. The purpose of this study was to identify the predictors of mortality with VA-ECMO support. Methods We retrospectively analyzed 195 adult patients who received VA-ECMO for refractory cardiogenic shock at our center between 2016 and 2023. Results Hundred-one(51.8%) patients died on ECMO,35(17.9%) patients had ECMO weaning but did not survive hospital discharge while 59(30.3%) patients survived and were discharged. 152 (77.9%) patients received VA-ECMO after cardiac surgery. The non-survivors had more frequencies of chronic kidney disease (24.3% vs. 8.5%, p=0.01), atrial fibrillation (36.8% vs. 16.9%, p=0.006), previous cardiotomies (50% vs. 32.2%, p=0.02), higher SOFA score at ECMO initiation 14(11,16) vs. 9(8,11), p0.001, lesser SAVE score -3(-6,0) vs. 3(1,5), p0.001 and higher levels of arterial lactate at ECMO initiation10.15(6.9,14.2) vs. 5.8 (4.8,8.4), p0.001, then at 12 h 11.7(7.7,19.65) vs. 4.1(2.7,6.3), p0.001 and 24 h 7.65 (4.2,20) vs. 1.9(1.4,2.7), p0.001 compared to the survivors. Logistic multivariable regression analysis revealed that initial SOFA score (OR: 1.67,95%CI: 1.345-2.072, p0.001), blood lactate level at 24 h (OR: 1.78, 95%CI: 1.33-2.27, p0.012) and atrial fibrillation (OR: 6.48,95% CI: 1.93-67.27, p=0.002) were the independent predictors of hospital mortality. Conclusion VA-ECMO still carries a significantly high hospital mortality. Identifying the predictors of mortality helps to prognosticate patients, which may help in clinical decision-making.Multivariable regression analysis

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Cite This Study

Laimoud et al. (Sat,) studied this question.

synapsesocial.com/papers/698585888f7c464f23008ee0 https://doi.org/https://doi.org/10.1093/eurheartj/ehaf784.2197

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