title: Predictors for quality of life of patients with a portable out-of-centre-implanted extracorporeal membrane oxygenation device.
abstract: Despite progress in the treatment of cardiopulmonary organ failure, the mortality rate for patients with acute respiratory distress syndrome (ARDS) and cardiogenic shock remains high. Extracorporeal membrane oxygenation (ECMO) is a promising treatment option, but long-term outcomes and health-related quality of life (HRQOL) are unknown.
  
  
  
  Detailed information related to pre- and post-device data and outcomes from a consecutive sample of 71 patients treated with ECMO was analysed. Long-term survivors were given a detailed follow-up examination after a median time of 31 months that included multiple scoring systems for HRQOL assessment.
  
  
  
  Seventy-one patients received a portable out-of-centre-implanted ECMO system. The survival rate at hospital discharge was 48%. Median HRQOL scores were 80% on the Karnofsky index (normal ≥80%), 80% on the Euroqol-5D (normal ≥75%) and 73.1% on the quality-of-life index (normal ≥70%). Mental scores were 96.7% on the Mini-Mental State Examination (normal ≥90.0%), 77.8% on the DemTect (normal ≥72.0%), 87.0% on the test for early detection of dementia with depression demarcation (TFDD; normal ≥74.0%) and confirmed good mental state and HRQOL for patients at follow-up. Univariate analysis for in-hospital mortality indicated that ventilation time before device implantation, higher Acute Physiology and Chronic Health Evaluation (APACHE) II score, higher lactate level at the time of ECMO implantation and female gender were associated with adverse outcomes.
  
  
  
  In our cohort of patients, survivors of out-of-hospital ECMO implantation demonstrated good mental and quality-of-life conditions with well-recovered cardiopulmonary function during long-term follow-up. The indicators for adverse outcomes, pre-implantation lactate levels, pre-ventilation time and APACHE II score, should be considered before implantation of an ECMO device.
  
  
  
  This study is registered at DRKS (Deutsches Register Klinischer Studien) under the code DRKS00009735 and was submitted to the WHO.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany.|Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Rückert
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Steinke
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Lilit
authors.initials: L
authors.lastname: Flöther
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Bucher
authors.affiliation: Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Metz
authors.affiliation: Department of Internal Medicine III, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Frantz
authors.affiliation: Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Efstratios I
authors.initials: EI
authors.lastname: Charitos
authors.affiliation: Department of Cardiac Surgery, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Treede
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Halle-Wittenberg University, Halle (Saale), Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Raspé
mesh_terms: D000328:Adult; D000368:Aged; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Extracorporeal membrane oxygenation; Health-related quality of life; Out-of-centre; Outcome assessment; Survival