https://scholars.lib.ntu.edu.tw/handle/123456789/433929
標題: | Survival analysis of extracorporeal membrane oxygenation in neonatal and pediatric patients – A nationwide cohort study | 作者: | Hsu J. CHIA-HSUIN CHANG Chiang L.-T. Caffrey J.L. JOU-WEI LIN YIH-SHARNG CHEN |
公開日期: | 2019 | 出版社: | Elsevier B.V. | 卷: | 118 | 期: | 9 | 起(迄)頁: | 1339-1346 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background: Extracorporeal membrane oxygenation (ECMO) provides short-term cardiopulmonary support for patients with acute cardiac and respiratory failure. This study reported the survival rate for pediatric patients from Taiwan's national cohort. Methods: Patients under the age of 18 who received ECMO from January 1, 2002 to December 31, 2012 were identified from the Taiwan National Health Insurance Research Database. The underlying etiology for ECMO use was categorized into post-operative (n = 410), cardiac (245), pulmonary (146) groups, and others (120). A Cox regression model was used to determine hazard ratios and to compare 30-day and 1-year survival rates using post-operative group as a reference. Results: The average age of all 921 patients was 4.83 ± 5.84 years, and 59.1% were male. The overall mortality rate was 29.2% at 1 month, and 46.9% at 1 year. The cardiac origin group, consisting mostly of congenital heart disease without surgical intervention, myocarditis, and heart failure had a better outcome with an adjusted hazard ratio of 0.69 (95% CI 0.49–0.96, p = 0.008) at 30 days and 0.50 (95% CI 0.38–0.66, p < 0.001) at 1 year, as compared to the post-operative group. Conclusion: In contrast to the widespread use of ECMO in respiratory distress syndrome in western countries, pediatric ECMO in Taiwan was more often applied to patients with underlying cardiovascular diseases. Mortality rates varied according to age groups and various etiologies. The results of this large pediatric cohort provides a different prospective in critical care outcomes in medical environments where ECMO is more widely available. ? 2018 Formosan Medical Association |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85059425522&doi=10.1016%2fj.jfma.2018.12.008&partnerID=40&md5=0cc31dccbc06f652f6cdc21fa172d43a https://scholars.lib.ntu.edu.tw/handle/123456789/433929 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2018.12.008 | SDG/關鍵字: | atropine; bicarbonate; dopamine; epinephrine; noradrenalin; vasopressin; acute kidney failure; Article; brain hemorrhage; brain ischemia; child; child hospitalization; cohort analysis; comparative study; congenital heart disease; extracorporeal oxygenation; female; gastrointestinal hemorrhage; groups by age; heart failure; human; infant; limb ischemia; major clinical study; male; mortality rate; myocarditis; national health insurance; newborn; outcome assessment; pediatric patient; postoperative care; preschool child; respiratory distress syndrome; survival analysis; survival rate; Taiwan; treatment duration; treatment indication; adolescent; epidemiology; extracorporeal oxygenation; factual database; heart failure; mortality; respiratory failure; resuscitation; Adolescent; Cardiopulmonary Resuscitation; Child; Child, Preschool; Cohort Studies; Databases, Factual; Extracorporeal Membrane Oxygenation; Female; Heart Failure; Humans; Infant; Infant, Newborn; Male; Respiratory Insufficiency; Survival Analysis; Taiwan |
顯示於: | 醫學系 |
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