Sex Differences in Patients With Cardiogenic Shock Receiving Venoarterial Extracorporeal Membrane Oxygenation.

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.