Neurologic complications of extracorporeal membrane oxygenation

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background and Purpose: The rate and outcomes of neurologic complications of patients receiving extracorporeal membrane oxygenation (ECMO) are poorly understood. The purpose of this study was to identify these parameters in ECMO patients. Methods: All patients receiving ECMO were selected from the Nationwide Inpatient Sample between 2001–2011. The rate and outcomes of neurologic complications [acute ischemic stroke, intracranial hemorrhage (ICH), and seizures] among these patients was determined. Discharge status, mortality, length of stay, and hospitalization costs were compared between patients with and without neurologic complications using chi-squared tests for categorical variables and Student’s t-test for continuous variables. Results: In total, 23,951 patients were included in this study, of which 2,604 (10.9%) suffered neurologic complications of seizure (4.1%), stroke (4.1%), or ICH (3.6%). When compared to patients without neurologic complications, acute ischemic stroke patients had significantly higher rates of discharge to a long-term facility (12.2% vs. 6.8%, p<0.0001) and a significantly longer mean length of stay (41.6 days vs. 31.9 days, p<0.0001). ICH patients had significantly higher rates of discharge to a long-term facility (9.5% vs. 6.8%, p=0.007), significantly higher mortality rates (59.7% vs. 50.0%, p<0.0001), and a significantly longer mean length of stay (41.8 days vs. 31.9 days) compared to patients without neurologic complications. These outcomes did not differ significantly between seizure patients and patients without neurologic complications. Conclusions: Given the increasing utilization of ECMO and the high costs and poor outcomes associated with neurologic complications, more research is needed to help determine the best way to prevent these sequelae in this patient population.

Original languageEnglish (US)
Pages (from-to)383-389
Number of pages7
JournalJournal of Clinical Neurology (Korea)
Volume11
Issue number4
DOIs
StatePublished - Jan 1 2015

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Extracorporeal Membrane Oxygenation
Nervous System
Intracranial Hemorrhages
Length of Stay
Seizures
Stroke
Costs and Cost Analysis
Mortality
Inpatients
Hospitalization

Keywords

  • Extracorporeal membrane oxygenation
  • Neurology/neurologic (deficits, disease, injury)
  • Stroke

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Neurologic complications of extracorporeal membrane oxygenation. / Nasr, Deena; Rabinstein, Alejandro.

In: Journal of Clinical Neurology (Korea), Vol. 11, No. 4, 01.01.2015, p. 383-389.

Research output: Contribution to journalArticle

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abstract = "Background and Purpose: The rate and outcomes of neurologic complications of patients receiving extracorporeal membrane oxygenation (ECMO) are poorly understood. The purpose of this study was to identify these parameters in ECMO patients. Methods: All patients receiving ECMO were selected from the Nationwide Inpatient Sample between 2001–2011. The rate and outcomes of neurologic complications [acute ischemic stroke, intracranial hemorrhage (ICH), and seizures] among these patients was determined. Discharge status, mortality, length of stay, and hospitalization costs were compared between patients with and without neurologic complications using chi-squared tests for categorical variables and Student’s t-test for continuous variables. Results: In total, 23,951 patients were included in this study, of which 2,604 (10.9{\%}) suffered neurologic complications of seizure (4.1{\%}), stroke (4.1{\%}), or ICH (3.6{\%}). When compared to patients without neurologic complications, acute ischemic stroke patients had significantly higher rates of discharge to a long-term facility (12.2{\%} vs. 6.8{\%}, p<0.0001) and a significantly longer mean length of stay (41.6 days vs. 31.9 days, p<0.0001). ICH patients had significantly higher rates of discharge to a long-term facility (9.5{\%} vs. 6.8{\%}, p=0.007), significantly higher mortality rates (59.7{\%} vs. 50.0{\%}, p<0.0001), and a significantly longer mean length of stay (41.8 days vs. 31.9 days) compared to patients without neurologic complications. These outcomes did not differ significantly between seizure patients and patients without neurologic complications. Conclusions: Given the increasing utilization of ECMO and the high costs and poor outcomes associated with neurologic complications, more research is needed to help determine the best way to prevent these sequelae in this patient population.",
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