Korean circulation journal · 2025
Sex Differences in Patients With Cardiogenic Shock Receiving Venoarterial Extracorporeal Membrane Oxygenation.
СтатьяНазвание и аннотация: Перевод в очереди
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Kim Onyou, Hong David, Choi Ki Hong, Lee Joo Myung, Park Taek Kyu, Song Young Bin, Hahn Joo-Yong, Choi Seung-Hyuk, Cho Yang Hyun, Gwon Hyeon-Cheol, Yang Jeong Hoon
Аннотация
BACKGROUND AND OBJECTIVES: Limited data are available on sex differences in clinical outcomes of patients with profound cardiogenic shock (CS) receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). Therefore, our study sought to compare clinical pictures and outcomes between male and female patients treated with VA-ECMO.
METHODS: A total of 1,328 patients receiving VA-ECMO were selected from either the Samsung Medical Center or a multicenter CS registry named the SMART RESCUE study. The study population was divided into men (n=903) and women (n=425). The primary outcome was in-hospital mortality, and the secondary outcome was procedure-related complications, which included limb ischemia, extracorporeal membrane oxygenation (ECMO) site bleeding and infection, and wound dehiscence.
RESULTS: There was no significant difference in in-hospital mortality (men vs. women, 46.4% vs. 45.6%; adjusted odds ratio [OR], 0.78; 95% confidence interval [CI], 0.58-1.05; p=0.106) based on multivariable analysis. Women showed higher rates of procedure-related complication than men (18.7% vs. 25.9%; adjusted OR, 1.82; 95% CI, 1.29-2.57; p=0.001) mainly driven by higher incidence of limb ischemia (7.1% vs. 12.9%; adjusted OR, 2.32; 95% CI, 1.42-3.78; p=0.001) On multivariable logistic regression analysis, female sex was an independent predictor of procedure-related complications (adjusted OR, 1.68; 95% CI, 1.13-2.49; p=0.009).
CONCLUSIONS: Although no significant difference in either in-hospital or mid-term mortality was found between men and women, female sex is an independent factor for ECMO-related complications.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02985008.
METHODS: A total of 1,328 patients receiving VA-ECMO were selected from either the Samsung Medical Center or a multicenter CS registry named the SMART RESCUE study. The study population was divided into men (n=903) and women (n=425). The primary outcome was in-hospital mortality, and the secondary outcome was procedure-related complications, which included limb ischemia, extracorporeal membrane oxygenation (ECMO) site bleeding and infection, and wound dehiscence.
RESULTS: There was no significant difference in in-hospital mortality (men vs. women, 46.4% vs. 45.6%; adjusted odds ratio [OR], 0.78; 95% confidence interval [CI], 0.58-1.05; p=0.106) based on multivariable analysis. Women showed higher rates of procedure-related complication than men (18.7% vs. 25.9%; adjusted OR, 1.82; 95% CI, 1.29-2.57; p=0.001) mainly driven by higher incidence of limb ischemia (7.1% vs. 12.9%; adjusted OR, 2.32; 95% CI, 1.42-3.78; p=0.001) On multivariable logistic regression analysis, female sex was an independent predictor of procedure-related complications (adjusted OR, 1.68; 95% CI, 1.13-2.49; p=0.009).
CONCLUSIONS: Although no significant difference in either in-hospital or mid-term mortality was found between men and women, female sex is an independent factor for ECMO-related complications.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02985008.