Ten-year territory-wide trends in the utilisation and clinical outcomes of extracorporeal membrane oxygenation in Hong Kong.

Autor:	Ng PY; Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China., Chan VWS; Department of Medicine, The University of Hong Kong, Hong Kong SAR, China., Ip A; Department of Medicine, The University of Hong Kong, Hong Kong SAR, China., Ling L; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China., Chan KM; Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China., Leung AKH; Department of Intensive Care, Queen Elizabeth Hospital, Hong Kong SAR, China., Chan KKC; Department of Intensive Care, Tuen Mun Hospital, Hong Kong SAR, China., So D; Department of Intensive Care, Princess Margaret Hospital, Hong Kong SAR, China., Shum HP; Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China., Ngai CW; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China., Chan WM; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China., Sin WC; Department of Adult Intensive Care, Queen Mary Hospital, Hong Kong SAR, China.; Department of Anaesthesiology, The University of Hong Kong, Hong Kong SAR, China.
Jazyk:	angličtina
Zdroj:	Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2023 Dec; Vol. 29 (6), pp. 514-523. Date of Electronic Publication: 2023 Nov 16.
DOI:	10.12809/hkmj2210025
Abstrakt:	Introduction: The utilisation of extracorporeal membrane oxygenation (ECMO) has been rapidly increasing in Hong Kong. This study examined 10-year trends in the utilisation and clinical outcomes of ECMO in Hong Kong. Methods: We retrospectively reviewed the records of all adult patients receiving ECMO who were admitted to the intensive care units (ICUs) of public hospitals in Hong Kong between 2010 and 2019. Temporal trends across years were assessed using the Mann-Kendall test. Observed hospital mortality was compared with the Acute Physiology and Chronic Health Evaluation (APACHE) IV-predicted mortality. Results: The annual number of patients receiving ECMO increased from 18 to 171 over 10 years. In total, 911 patients received ECMO during the study period: 297 (32.6%) received veno-arterial ECMO, 450 (49.4%) received veno-venous ECMO, and 164 (18.0%) received extracorporeal cardiopulmonary resuscitation. The annual number of patients aged ≥65 years increased from 0 to 47 (27.5%) [P for trend=0.001]. The median (interquartile range) Charlson Comorbidity Index increased from 1 (0-1) to 2 (1-3) [P for trend<0.001] while the median (interquartile range) APACHE IV score increased from 90 (57-112) to 105 (77-137) [P for trend=0.003]. The overall standardised mortality ratio comparing hospital mortality with APACHE IV-predicted mortality was 1.11 (95% confidence interval=1.01-1.22). Hospital and ICU length of stay both significantly decreased (P for trend=0.011 and <0.001, respectively). Conclusion: As ECMO utilisation increased in Hong Kong, patients put on ECMO were older, more critically ill, and had more co-morbidities. It is important to combine service expansion with adequate resource allocation and training to maintain quality of care. Competing Interests: All authors have disclosed no conflicts of interest.
Databáze:	MEDLINE
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