Abstract W MP25: Stroke Outcomes in Patients Receiving Extracorporeal Membranous Oxygenation
Objective: Using the Nationwide Inpatient Sample (NIS), we determined morbidity, mortality and trends in ischemic and hemorrhagic stroke complications in patients receiving Extracorporeal Membranous Oxygenation (ECMO).
Materials and Methods: Using the NIS from 2001-2011, patients receiving ECMO were identified. We analyzed their ischemic and hemorrhagic stroke complication rates and compared discharge status between these patients and those without cerebrovascular complications. Morbidity was defined as discharge to a long-term facility. Ischemic and hemorrhagic stroke rates were compared between two time periods (2001-2006 and 2007-2011). Continuous variables were compared with a student’s t-test and categorical variables were compared with the chi-squared test.
Results: A total of 23,950 ECMO patients were included in this study of which 22108 patients (92.3%) had no cerebrovascular complications, 980 patients (4.1%) had ischemic stroke and 862 patients (3.6%) had hemorrhagic stroke. Of those without cerebrovascular complications there was a 49.9% mortality rate and a 6.8% morbidity rate. Patients with ischemic stroke had a mortality rate of 44.3% (P=0.0006) and a morbidity rate of 14.6% (P<0.0001). Patients with hemorrhagic stroke had a mortality rate of 59.7% (P<0.0001) and a morbidity rate of 9.5% (P=0.002). The proportion of patients with ischemic stroke increased from 2.8% in 2001-2006 to 5.1% in 2007-2011 (P<0.0001) and patients with hemorrhagic stroke increased from 2.4% in 2001-2006 to 4.5% in 2007-2011(P<0.0001).
Conclusion: ECMO patients complicated with ischemic and hemorrhagic stroke had higher morbidity than those with no cerebrovascular complications. Patients with hemorrhagic stroke had a 10% worsened mortality rate than those with no cerebrovascular complications. The proportion of ECMO patients with cerebrovascular complications has nearly doubled between 2001-2011.
Author Disclosures: D. Nasr: None. A. Rabinstein: None.
- © 2014 by American Heart Association, Inc.