Bilirubin-A Possible Prognostic Mortality Marker for Patients with ECLS

Area of Science:

• Cardiology
• Critical Care Medicine
• Hepatology

Background:

• Extracorporeal life support (ECLS) offers a therapeutic option for refractory cardiogenic shock.
• High mortality rates necessitate early prognostic markers for ECLS therapy success or futility.

Purpose of the Study:

• To investigate liver enzyme levels, specifically bilirubin, as potential prognostic mortality markers in adult patients undergoing ECLS.
• To assess the association between day 5 serum bilirubin levels and in-hospital mortality in ECLS patients.

Main Methods:

• Retrospective single-center cohort study of 298 adult patients receiving ECLS between 2011 and 2018.
• Analysis of serum bilirubin, GOT, and GPT levels on day 5 post-ECLS initiation.
• Primary endpoint: all-cause in-hospital mortality.

Main Results:

• Overall in-hospital mortality rate was 42.6%.
• Serum bilirubin on day 5 showed an AUC of 0.72 for predicting mortality.
• Multivariable Cox regression revealed bilirubin on day 5 as an independent predictor of mortality (HR: 2.24).

Conclusions:

• Increased serum bilirubin levels on day 5 of ECLS therapy are independently associated with higher in-hospital mortality.
• Bilirubin may serve as an early prognostic marker for predicting outcomes in patients receiving ECLS for cardiogenic shock.