Body mass index does not impact survival in COVID-19 patients requiring veno-venous extracorporeal membrane oxygenation.
| Autor: | Powell, Elizabeth K, Haase, Daniel J, Lankford, Allison, Boswell, Kimberly, Esposito, Emily, Hamera, Joseph, Dahi, Siamak, Krause, Eric, Bittle, Gregory, Deatrick, Kristopher B, Young, Bree Ann C, Galvagno Jr, Samuel M, Tabatabai, Ali |
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| Předmět: |
ADULT respiratory distress syndrome treatment
OBESITY STATISTICS KRUSKAL-Wallis Test COVID-19 CONFIDENCE intervals MULTIVARIATE analysis EXTRACORPOREAL membrane oxygenation RETROSPECTIVE studies ACQUISITION of data HOSPITAL mortality SEVERITY of illness index COMPARATIVE studies MEDICAL records DESCRIPTIVE statistics BODY mass index LOGISTIC regression analysis ODDS ratio DATA analysis software BLOOD filtration |
| Zdroj: | Perfusion; Sep2023, Vol. 38 Issue 6, p1174-1181, 8p |
| Abstrakt: | Introduction: With the increased demand for veno-venous extracorporeal membrane oxygenation (VV ECMO) during the COVID-19 pandemic, guidelines for patient candidacy have often limited this modality for patients with a body mass index (BMI) less than 40 kg/m2. We hypothesize that COVID-19 VV ECMO patients with at least class III obesity (BMI ≥ 40) have decreased in-hospital mortality when compared to non-COVID-19 and non-class III obese COVID-19 VV ECMO populations. Methods: This is a single-center retrospective study of COVID-19 VV ECMO patients from January 1, 2014, to November 30, 2021. Our institution used BMI ≥ 40 as part of a multi-disciplinary VV ECMO candidate screening process in COVID-19 patients. BMI criteria were not considered for exclusion criteria in non-COVID-19 patients. Univariate and multivariable analyses were performed to assess in-hospital mortality differences. Results: A total of 380 patients were included in our analysis: The COVID-19 group had a lower survival rate that was not statistically significant (65.7% vs.74.9%, p =.07). The median BMI between BMI ≥ 40 COVID-19 and non-COVID-19 patients was not different (44.5 vs 45.5, p =.2). There was no difference in survival between the groups (73.3% vs. 78.5%, p =.58), nor was there a difference in survival between the COVID-19 BMI ≥ 40 and BMI < 40 patients (73.3, 62.7, p =.29). Multivariable logistic regression with the outcome of in-hospital mortality was performed and BMI was not found to be significant (OR 0.99, 95% CI 0.89, 1.01; p =.92). Conclusion: BMI ≥ 40 was not an independent risk factor for decreased in-hospital survival in this cohort of VV ECMO patients at a high-volume center. BMI should not be the sole factor when deciding VV ECMO candidacy in patients with COVID-19. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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