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Outcome of elderly undergoing extracorporeal life support in refractory cardiogenic shock

Suzanne de Waha1,2, Tobias Graf3,4, Steffen Desch3,4

  • 1University Heart Centre Luebeck, Department of Cardiology, Angiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Luebeck, Germany. suzanne.dewaha@uksh.de.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|January 18, 2017
PubMed

Insights

Elderly patients (over 60) with refractory cardiogenic shock (CS) undergoing extracorporeal life support (ECLS) have higher mortality rates despite similar initial ECLS weaning success compared to younger patients.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Interventional Cardiology

Background:

  • Real-world data on refractory cardiogenic shock (CS) patients treated with extracorporeal life support (ECLS).
  • Comparison of outcomes between elderly (>60 years) and younger (≤60 years) patient groups.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of ECLS in elderly versus younger patients with refractory CS.
  • To compare mid-term survival rates between age groups after ECLS implantation.

Main Methods:

  • Retrospective analysis of 100 consecutive patients with refractory CS undergoing percutaneous ECLS.
  • Patients stratified into two groups based on median age: ≤60 years and >60 years.
  • Follow-up at hospital discharge and a median of 18 months post-procedure.

Main Results:

  • ECLS weaning success was similar between age groups (56% overall, p=1.00).
  • In-hospital mortality was significantly higher in the elderly group (82% vs 58%, p=0.02).
  • Mid-term mortality at 18 months was 94% in patients >60 years versus 68% in patients ≤60 years (p=0.001).

Conclusions:

  • While initial ECLS weaning is achievable in older patients, their mid-term prognosis is significantly poorer.
  • Age is a critical factor influencing long-term survival outcomes in CS patients treated with ECLS.
  • Younger patients (≤60 years) demonstrate superior mid-term survival following ECLS for refractory CS.
Abstract

Keywords:
Active support deviceAgeExtracorporeal life supportPrognosisRefractory cardiogenic shock

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