Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients-the ECMO quality improvement action (EQIA) study: a national cohort study in China from 2017 to 2019

被引：3

作者：

Cheng, Wei ^{[1
]}

Chen, Jieqing ^{[2
]}

Ma, Xudong ^{[3
]}

Sun, Jialu ^{[7
]}

Gao, Sifa ^{[3
]}

Wang, Ye ^{[4
]}

Su, Longxiang ^{[1
]}

Wang, Lu ^{[1
]}

Du, Wei ^{[1
]}

He, Huaiwu ^{[1
]}

Chen, Yujie ^{[1
]}

Li, Zunzhu ^{[1
]}

Li, Qi ^{[1
]}

Sun, Jianhua ^{[1
]}

Luo, Hongbo ^{[1
]}

Liu, Jinbang ^{[1
]}

Shan, Guangliang ^{[5
,6
]}

Du, Bing ^{[3
]}

Guo, Yanhong ^{[3
]}

Liu, Dawei ^{[1
]}

Yin, Chang ^{[7
]}

Zhou, Xiang ^{[1
,2
]}

机构：

[1] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Crit Care Med, State Key Lab Complex Severe & Rare Dis, Beijing 100730, Peoples R China

[2] Chinese Acad Med Sci & Peking Union Med Coll, Peking Union Med Coll Hosp, Informat Ctr Dept, Dept Informat Management,State Key Lab Complex Se, Beijing 100730, Peoples R China

[3] Natl Hlth Commiss Peoples Republ China, Dept Med Adm, Beijing 100044, Peoples R China

[4] Chinese Acad Med Sci & Peking Union Med Coll, Sch Populat Med & Publ Hlth, Beijing 100730, Peoples R China

[5] Chinese Acad Med Sci CAMS, Inst Basic Med Sci, Dept Epidemiol & Biostat, Beijing 100730, Peoples R China

[6] Peking Union Med Coll, Sch Basic Med, Beijing 100730, Peoples R China

[7] Natl Hlth Commiss Peoples Republ China, Natl Inst Hosp Adm, Beijing 100044, Peoples R China

来源：

FRONTIERS OF MEDICINE | 2024年 / 18卷 / 02期

基金：

国家重点研发计划;

关键词：

veno-venous extracorporeal membrane oxygenation; in-hospital mortality; high-volume centers; quality control; intensive care unit capacity parameters; EXTRACORPOREAL MEMBRANE-OXYGENATION; ORGANIZATION; COVID-19; INDICATORS; GUIDELINES; INFECTION; VOLUME;

D O I：

10.1007/s11684-023-1014-x

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

This cohort study was performed to explore the influence of intensive care unit (ICU) quality on in-hospital mortality of veno-venous (V-V) extracorporeal membrane oxygenation (ECMO)-supported patients in China. The study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019, using data from the National Clinical Improvement System and China National Critical Care Quality Control Center. ICU quality was assessed by quality control indicators and capacity parameters. Among the 2563 V-V ECMO-supported patients in 318 hospitals, a significant correlation was found between ECMO-related complications and prognosis. The reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients (cutoff: 1.5% and 7.0%; 95% confidence interval: 1.05-1.48 and 1.04-1.45; odds ratios: 1.25 and 1.23; P = 0.012 and P = 0.015, respectively). Meanwhile, the V-V ECMO center volume was a protective factor (cutoff of >= 50 cases within the 3-year study period; 95% confidence interval: 0.57-0.83, odds ratio: 0.69, P = 0.0001). The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these findings. Thus, ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

引用

页码：315 / 326

页数：12

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