Predicting mortality in nonsurgical patients before cannulation for veno‐arterial extracorporeal life support: Development and validation of the LACT‐8 score

Objectives We sought to derive and validate a model to predict inpatient mortality after veno‐arterial extracorporeal life support (VA‐ECLS) based on readily available, precannulation clinical data. Background Refractory cardiogenic shock supported by VA‐ECLS is associated with high morbidity and mo...

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Published in:Catheterization and cardiovascular interventions 2022-03, Vol.99 (4), p.1115-1124
Main Authors: Hillerson, Dustin, Whiteside, Hoyle L., Dugan, Adam J., Coots, Riley D., Tribble, Thomas A., Abdel‐Latif, Ahmed, Ogunbayo, Gbolahan O., Duncan, Meredith S., Gupta, Vedant A.
Format: Article
Language:English
Subjects:
Cannulation
cardiogenic shock
Catheterization
Coma
Extracorporeal membrane oxygenation
Hemoglobin
Hospital Mortality
Humans
Lactic Acid
mechanical circulatory support
Morbidity
Mortality
outcome
Patients
Retrospective Studies
Shock, Cardiogenic - diagnosis
Shock, Cardiogenic - therapy
Treatment Outcome
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Summary:Objectives We sought to derive and validate a model to predict inpatient mortality after veno‐arterial extracorporeal life support (VA‐ECLS) based on readily available, precannulation clinical data. Background Refractory cardiogenic shock supported by VA‐ECLS is associated with high morbidity and mortality. Methods VA‐ECLS cases at our institution from January 2014 through July 2019 were retrospectively reviewed. Exclusion criteria were cannulation: (1) at another institution; (2) for primary surgical indication; or (3) for extracorporeal cardiopulmonary resuscitation. Multivariable logistic regression compared those with and without inpatient mortality. Multiple imputation was performed and optimism‐adjusted area under the curve (oAUC) values were computed. Results VA‐ECLS cases from August 2019 through November 2020 were identified as a validation cohort. In the derivation cohort (n = 135), the final model included Lactate (mmol/L), hemoglobin (g/dl; Anemia), Coma (Glasgow Coma Scale [GCS] 8) and hemoglobin (
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30106