OBJECTIVES: Information is lacking about long-term survival and quality of life (QOL) after treating patients on extracorporeal life support. METHODS: Outcome data were assessed by phone interviews, a QOL analysis using the EuroQol 5-dimensions questionnaire and a retrospective inquiry of the Regensburg ECMO Registry database for the decade 2006-2015. A statistical analysis was obtained by comparing patients with a cardiosurgical intervention (CS = 189 patients) with those without (w/oCS = 307 patients). RESULTS: Survival to discharge in the w/oCS group was higher than that in the CS group (w/oCS: 41.7% vs CS: 29.5%; P = 0.004). A Kaplan-Meier analysis showed a significant difference between both groups in favour of patients w/oCS (log rank P = 0.02). This difference was no longer statistically significant after propensity score matching ( P = 0.07). The 1- and 2-year survival rates of discharged patients were 67% and 50% in the w/oCS group vs 60% and 45% in the CS group (log rank P = 0.29). Eighty-two patients answered the QOL questionnaire after a mean follow-up time of 4.2 ± 2.9 years. A total of 75% could handle their daily life; 57% were not limited in their usual activities. Mobility impairment was noted in 50%; 25% returned to work or school. There were no differences in the EuroQol 5-dimension indices between the patient groups. However, compared to a normative age-matched population, significantly lower indices were calculated. CONCLUSIONS: Long-term survival rates in patients requiring extracorporeal life support are acceptable with a probable advantage for patients without an operation and a narrowed QOL. The results are promising and encouraging, but there is also a need for improvement.
OBJECTIVES: Information is lacking about long-term survival and quality of life (QOL) after treating patients on extracorporeal life support. METHODS: Outcome data were assessed by phone interviews, a QOL analysis using the EuroQol 5-dimensions questionnaire and a retrospective inquiry of the Regensburg ECMO Registry database for the decade 2006-2015. A statistical analysis was obtained by comparing patients with a cardiosurgical intervention (CS = 189 patients) with those without (w/oCS = 307 patients). RESULTS: Survival to discharge in the w/oCS group was higher than that in the CS group (w/oCS: 41.7% vs CS: 29.5%; P = 0.004). A Kaplan-Meier analysis showed a significant difference between both groups in favour of patients w/oCS (log rank P = 0.02). This difference was no longer statistically significant after propensity score matching ( P = 0.07). The 1- and 2-year survival rates of discharged patients were 67% and 50% in the w/oCS group vs 60% and 45% in the CS group (log rank P = 0.29). Eighty-two patients answered the QOL questionnaire after a mean follow-up time of 4.2 ± 2.9 years. A total of 75% could handle their daily life; 57% were not limited in their usual activities. Mobility impairment was noted in 50%; 25% returned to work or school. There were no differences in the EuroQol 5-dimension indices between the patient groups. However, compared to a normative age-matched population, significantly lower indices were calculated. CONCLUSIONS: Long-term survival rates in patients requiring extracorporeal life support are acceptable with a probable advantage for patients without an operation and a narrowed QOL. The results are promising and encouraging, but there is also a need for improvement.
Authors: Annemieke Oude Lansink-Hartgring; Dinis Dos Reis Miranda; Dirk W Donker; Jacinta J Maas; Thijs Delnoij; Marijn Kuijpers; Judith van den Brule; Erik Scholten; Hendrik Endeman; Alexander P J Vlaar; Walter M van den Bergh Journal: BMC Health Serv Res Date: 2018-03-09 Impact factor: 2.655