title: Application of the Age, Creatinine, and Left Ventricular Ejection Fraction Score for Patients on Extracorporeal Membrane Oxygenation.
abstract: Patients on extracorporeal membrane oxygenation (ECMO) usually have high mortality rate and poor outcome. Age, Creatinine, and Left Ventricular Ejection Fraction (ACEF) score is an easy-calculating score and provides good performance on mortality prediction in patients undergoing cardiac operations or percutaneous coronary intervention, but it has not been applied to patients on ECMO before. In this study, we aimed to use ACEF score obtained within 1 week of ECMO support for in-hospital mortality prediction in patients on ECMO due to severe myocardial failure. This study reviewed the medical records of 306 patients on ECMO at a specialized intensive care unit (CVSICU) in a tertiary-care university hospital between March 2002 and December 2011, and 105 patients on veno-arterial ECMO due to severe myocardial failure were enrolled. Demographic, clinical, and laboratory variables were retrospectively collected as survival predictors. The overall mortality rate was 47.6%. The most frequent condition requiring ICU admission was postcardiotomy cardiogenic shock. Multiple logistic regression analysis indicated that post-ECMO ACEF score, Sequential Organ Failure Assessment score, and troponin I on day 1 of ECMO support were independent risk factors for in-hospital mortality. Using the area under the receiver operating characteristic curve (AUROC), the post-ECMO ACEF score indicated a good discriminative power (AUROC 0.801 ± 0.042). Finally, cumulative survival rates at 6-month follow-up differed significantly (P < 0.001) for an ACEF score ≤ 2.22 versus those with an ACEF score > 2.22. After ECMO treatment due to severe myocardial failure, post-ECMO ACEF score provides an easy-calculating method with a reproducible evaluation tool with excellent prognostic abilities in these patients.
authors: Department of Nephrology, Taipei.
authors: Tsung-Yu
authors: TY
authors: Tsai
authors: Division of Cardiovascular Surgery, Chang Gung Memorial Hospital, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Feng-Chun
authors: FC
authors: Tsai
authors: Department of Nephrology, Taipei.
authors: Pei-Chun
authors: PC
authors: Fan
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Chih-Hsiang
authors: CH
authors: Chang
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Chan-Yu
authors: CY
authors: Lin
authors: Department of Nephrology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
authors: Wei-Wen
authors: WW
authors: Chang
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Shen-Yang
authors: SY
authors: Lee
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Hsiang-Hao
authors: HH
authors: Hsu
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Ya-Chung
authors: YC
authors: Tian
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Ji-Tseng
authors: JT
authors: Fang
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Chih-Wei
authors: CW
authors: Yang
authors: Department of Nephrology, Taipei.|Chang Gung University College of Medicine, Taipei.
authors: Yung-Chang
authors: YC
authors: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003404:Creatinine / Q000097:blood*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume; D016019:Survival Analysis; D015996:Survival Rate; D016277:Ventricular Function, Left
chemical_list: D003404:Creatinine
keywords: Creatinine; Extracorporeal membrane oxygenation-Age; Left ventricular ejection fraction-Heart failure-Echocardiography