Cross-sectional study for the clinical application of extracorporeal membrane oxygenation in Mainland China, 2018
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RESEARCH
Open Access
Cross-sectional study for the clinical application of extracorporeal membrane oxygenation in Mainland China, 2018 Wei Cheng1†, Xu-Dong Ma2†, Long-Xiang Su1†, Huai-Wu He1, Lu Wang1, Bo Tang1, Wei Du1, Yuan-kai Zhou1, Hao Wang1, Na Cui1, Yun Long1, Da-Wei Liu1, Yan-Hong Guo2, Ye Wang3, Guang-Liang Shan3, Xiang Zhou1* , Shu-Yang Zhang4 and Yu-Pei Zhao5
Abstract Background: To investigate the epidemiology and in-hospital mortality of veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in Mainland China throughout 2018. Methods: Patients supported by ECMO from 1700 tertiary hospitals in 31 provinces from January 1 to December 31, 2018, were selected from the National Clinical Improvement System database. Results: The 1700 included hospitals had 2073 cases of ECMO in 2018, including 714 VV and 1359 VA ECMOs. The average patient age was 50 years (IQR 31–63), and 1346 were male. The average hospital stay was 17 days (IQR 7– 30), and the average costs per case was $36,334 (IQR 22,547–56,714). The three provinces with the highest number of ECMO cases were Guangdong, Beijing, and Zhejiang; the southeast coastal areas and regions with higher GDP levels had more cases. Overall in-hospital mortality was 29.6%. Mortality was higher among patients who were male, over 70 years old, living in underdeveloped areas, and who were treated during the summer. Mortality in provinces with more ECMO cases was relatively low. The co-existence of congenital malformations, blood system abnormalities, or nervous system abnormalities increased in-hospital mortality. Conclusions: Mortality and medical expenses of ECMO among patients in China were relatively low, but large regional and seasonal differences were present. Risk factors for higher in-hospital mortality were older age, male sex, in underdeveloped areas, and treatment during the summer. Additionally, congenital malformations and blood system and nervous system abnormalities were associated with in-hospital mortality. Keywords: Extracorporeal membrane oxygenation, Epidemiology, Mortality, Complication, China
* Correspondence: [email protected] † Wei Cheng, Xu-Dong Ma and Long-Xiang Su contributed equally to this work. 1 Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, 1 Shuaifuyuan, Dongcheng District, Beijing, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the artic
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