title: Long-term outcomes of patients undergoing extracorporeal membrane oxygenation for refractory postcardiotomy cardiogenic shock.
abstract: OBJECTIVE
  Postcardiotomy cardiogenic shock is still associated with a poor prognosis. We reviewed patients undergoing extracorporeal membrane oxygenation (ECMO) support for postcardiotomy cardiogenic shock and assessed their long-term outcomes.
  
  
  METHODS
  The subjects were 47 patients who received ECMO support for cardiogenic shock after open heart surgery. We analyzed the long-term survival and risk factors for early or late death.
  
  
  RESULTS
  Twenty-nine patients were weaned off ECMO support, but 15 of these patients died during their hospital stay. An independent predictor of mortality during ECMO support was incomplete sternum closure (OR 4.089, 95 % CL 1.003-16.67, p = 0.049) and a predictor of mortality after weaning off ECMO was more than 48 h of support (OR 8.975, 95 % CL 1.281-62.896, p = 0.027). Fourteen patients were discharged from hospital, but seven of these patients died during the follow-up period owing to cardiac events (n = 2) or non-cardiac causes (n = 5). The actuarial survival rates were 34.0 % at 30 days, 29.8 % at 1 year, and 17.6 % at 10 years.
  
  
  CONCLUSIONS
  Although postcardiotomy cardiogenic shock requiring ECMO support is associated with high morbidity and mortality, the long-term survival rate is acceptable.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Ooyaguchi-kami-machi, Itabashi-ku, Tokyo, 173-8610, Japan. unosaw@gmail.com
authors.forename: Satoshi
authors.initials: S
authors.lastname: Unosawa
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Kinichi
authors.initials: K
authors.lastname: Nakata
authors.forename: Isamu
authors.initials: I
authors.lastname: Yoshitake
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Haruka
authors.initials: H
authors.lastname: Kimura
authors.forename: Kana
authors.initials: K
authors.lastname: Takahashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hata
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult