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Earlier Application of Percutaneous Cardiopulmonary Support Rescues Patients from Severe Cardiopulmonary Failure Using the APACHE III Scoring System

Authors
 Suk-Won Song  ;  Hong-Suk Yang  ;  Sak Lee  ;  Young-Nam Youn  ;  Kyung-Jong Yoo 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.24(6) : 1064-1070, 2009 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2009
MeSH
APACHE* ; Adult ; Aged ; Aged, 80 and over ; Cardiopulmonary Resuscitation*/methods ; Cardiopulmonary Resuscitation*/utilization ; Catecholamines/therapeutic use ; Female ; Heart Failure/mortality ; Heart Failure/therapy* ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome
Keywords
Extracorporeal Membrane Oxygenation ; Outcomes
Abstract
Percutaneous cardiopulmonary support (PCPS) is a widely accepted treatment for severe cardiopulmonary failure. This system, which uses a percutaneous approach and autopriming devices, can be rapidly applied in emergency situations. We sought to identify the risk factors that could help predict in-hospital mortality, and to assess its outcomes in survivors. During a 2-yr period, 50 patients underwent PCPS for the treatment of severe cardiopulmonary failure, and of those, 22 (44%) were classified as survivors and 28 (56%) as non-survivors. We compared the 2 groups for risk factors of in-hospital mortality and to establish proper PCPS timing. Twenty patients underwent PCPS for acute myocardial infarction, 20 for severe cardiopulmonary failure after cardiac surgery, 7 for acute respiratory distress syndrome, and 3 for acute myocarditis. Multivariate analysis showed that an acute physiology, age, and chronic health evaluation (APACHE) III score > or =50 prior to PCPS was the only significant predictor of in-hospital mortality (P=0.001). Overall 18-month survival was 42.2%. Cox analysis showed patients with APACHE III scores > or =50 had a poor prognosis (P=0.001). Earlier application of PCPS, and other preemptive strategies designed to optimize high-risk patients, may improve patient outcomes. Identifying patients with high APACHE scores at the beginning of PCPS may predict in-hospital mortality. Survivors, particularly those with higher APACHE scores, may require more frequent follow-up to improve overall survival
Files in This Item:
T200903368.pdf Download
DOI
10.3346/jkms.2009.24.6.1064
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Youn, Young Nam(윤영남)
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/104960
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