Thorac Cardiovasc Surg 2022; 70(S 01): S1-S61
DOI: 10.1055/s-0042-1742930
Oral and Short Presentations
Tuesday, February 22
Extracorporeal Support: Systemic Effects

Obesity-Associated Effect on In-Hospital Outcomes in Patients Receiving VA ECMO

B. Ivanov
1   Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
,
I. Djordjevic
2   Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
,
S. Gerfer
2   Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
,
C. Gaisendrees
2   Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
,
K. Eghbalzadeh
2   Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
,
P. Risteski
3   Helios Klinikum Siegburg, Department of Cardiovascular Surgery, Siegburg, Deutschland
,
E. Kuhn
1   Department of Cardiac Surgery, Heart Center Cologne, Köln, Deutschland
,
A. Sabashnikov
2   Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
,
T. Wahlers
2   Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
,
P. Rahmanian
2   Department of Cardiac Surgery, Heart Center Cologne, Cologne, Deutschland
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Background: Obesity is known to impact outcomes of patients undergoing in-patient care in general. The association between extracorporeal membrane oxygenation (ECMO) and obesity related outcomes remains still unclear. Therefore, we sought to investigate weight associated differences in patients undergoing ECMO treatment.

Method: A retrospective study was performed for patients who received veno-arterial (VA) ECMO support at our tertiary ECMO center between 2006 and 2016. Patients were divided into non-obese (18.5–29–9 kg/m2) and obese (≥30 kg/m2) groups and analyzed in regard of baseline, ECMO-related and outcome parameter.

Results: A total of 244 patients received VA ECMO support during the study period (non-obese n = 179; obese n = 59). Obese patients were significantly older (p = 0.022) and suffered significantly more diabetes (21% non-obese vs. 48% obese; p < 0.001). Indication for support, laboratory parameter prior to ECMO, and ECMO related outcomes did not differ between the groups. Obese patients showed a trend toward higher in-hospital mortality (70% non-obese vs. 81% obese; p = 0.085). Subgroup analysis of status associated impact on in-hospital mortality showed the highest incidence of mortality in obese class II patients (93%) ([Table 1]).

Table 1

Outcomes of patients with postcardiotomy cardiogenic shock and ECMO therapy

Parameter

Non-obese (n = 179)

Obese (n = 59)

p-Value

In-hospital mortality

125 (70%)

48 (81%)

0.085

Length of stay (days)

12(6;26)

10(6;16)

0.270

Ventilation time (days)

8(5;18)

8(4;16)

0.525

Abdominal complication

41 (23%)

8 (14%)

0.100

Neurological complication

41 (23%)

11 (19%)

0.427

Dialysis

109 (61%)

34 (58%)

0.495

Sepsis

36 (20%)

11 (19%)

0.760

Conclusion: Obesity is associated with poorer outcomes in patients with VA ECMO therapy. Among all status, obese class II patients showed the highest risk of death. Therefore, weight should be incorporated into decision-making processes prior to ECMO implantation. Further randomized studies are required to define potential thresholds of weight in VA ECMO patients.



Publication History

Article published online:
03 February 2022

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