{
    "abstract": "The usage of extracorporeal membrane oxygenation (ECMO) in trauma patients has increased significantly within the past decade. Despite increased research on ECMO application in trauma patients, there remains limited data on factors predicting morbidity and mortality outcome. Therefore, the primary objective of this study is to describe patient characteristics that are independently associated with mortality in ECMO therapy in trauma patients, to further guide future research.\nThis retrospective study was conducted using the Trauma Quality Improvement Program database from 2010 to 2019. All adult (age \u2265 16\u00a0y) trauma patients that utilized ECMO were included. A Significant differences (P < 0.05) in demographic and clinical characteristics between groups were calculated using an independent t-test for normal distributed continuous values, a Mann-Whitney U test for non-normal distributed values, and a Pearson chi-square test for categorical values. A multivariable regression model was used to identify independent predictors for mortality. A survival flow chart was constructed by using the strongest predictive value for mortality and using the optimal cut-off point calculated by the Youden index.\nFive hundred forty-two patients were included of whom 205 died. Multivariable analysis demonstrated that the female gender, ECMO within 4\u00a0h after presentation, a decreased Glasgow Coma Scale, increased age, units of blood in the first 4\u00a0h, and abbreviated injury score for external injuries were independently associated with mortality in ECMO trauma patients. It was found that an external abbreviated injury score of \u22653 had the strongest predictive value for mortality, as patients with this criterion had an overall 29.5% increased risk of death.\nThere is an ongoing increasing trend in the usage of ECMO in trauma patients. This study has identified multiple factors that are individually associated with mortality. However, more research must be done on the association between mortality and noninjury characteristics like Pao2/Fio2 ratio, acute respiratory distress syndrome classification, etc. that reflect the internal state of the patient.",
    "authors": [
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Trauma Surgery, Leiden University Medical Center, Leiden, Netherlands.",
            "firstname": "Joep J J",
            "initials": "JJJ",
            "lastname": "Ouwerkerk"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "Ander",
            "initials": "A",
            "lastname": "Dorken-Gallastegi"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "Benjamin C",
            "initials": "BC",
            "lastname": "Renne"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "Spencer",
            "initials": "S",
            "lastname": "Lord"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "Shuhan",
            "initials": "S",
            "lastname": "He"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Trauma Surgery, Leiden University Medical Center, Leiden, Netherlands.",
            "firstname": "Elaine P X",
            "initials": "EPX",
            "lastname": "van Ee"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "Dias",
            "initials": "D",
            "lastname": "Argandykov"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "Jefferson A",
            "initials": "JA",
            "lastname": "Proa\u00f1o-Zamudio"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "John O",
            "initials": "JO",
            "lastname": "Hwabejire"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "Haytham M A",
            "initials": "HMA",
            "lastname": "Kaafarani"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.",
            "firstname": "George C",
            "initials": "GC",
            "lastname": "Velmahos"
        },
        {
            "affiliation": "Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: jarone.lee@mgh.harvard.edu.",
            "firstname": "Jarone",
            "initials": "J",
            "lastname": "Lee"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2023 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.jss.2023.07.022",
    "journal": "The Journal of surgical research",
    "keywords": [
        "Extracorporeal membrane oxygenation",
        "Mortality",
        "Trauma"
    ],
    "methods": null,
    "publication_date": "2023-08-12",
    "pubmed_id": "37567030",
    "results": "Five hundred forty-two patients were included of whom 205 died. Multivariable analysis demonstrated that the female gender, ECMO within 4\u00a0h after presentation, a decreased Glasgow Coma Scale, increased age, units of blood in the first 4\u00a0h, and abbreviated injury score for external injuries were independently associated with mortality in ECMO trauma patients. It was found that an external abbreviated injury score of \u22653 had the strongest predictive value for mortality, as patients with this criterion had an overall 29.5% increased risk of death.",
    "title": "Predictors of Mortality in Extracorporeal Membrane Oxygenation Support Patients Following Major Trauma.",
    "xml": "<Element 'PubmedArticle' at 0x788504b0d3f0>"
}