Risk Factors of Mortality and Long-Term Survival in Burn Patients With/Without Extracorporeal Membrane Oxygenation: A...

Area of Science:

• Critical Care Medicine
• Burn Surgery
• Cardiopulmonary Support

Background:

• Burn patients are at high risk for cardiopulmonary failure.
• Extracorporeal membrane oxygenation (ECMO) shows potential but its effectiveness and long-term survival in burn patients are not well-established.

Purpose of the Study:

• To assess mortality risk factors and long-term survival in burn patients treated with and without ECMO.
• To analyze the impact of ECMO on mortality based on burn severity (Total Body Surface Area - TBSA).

Main Methods:

• A case-control study using Taiwan's National Health Insurance Research Database (2000-2015).
• Propensity score matching was employed to balance patient characteristics (sex, age, TBSA, index date).
• Mortality and survival risk factors were analyzed in groups with and without ECMO.

Main Results:

• The study included 4,556 burn patients with ECMO and an equal number without.
• Higher mortality was observed in the ECMO group (54.41%) compared to the non-ECMO group (40.94%) (p < 0.001).
• Factors associated with mortality included male sex, age >65, TBSA ≥30%, escharotomy, hemodialysis, and bacteremia. ECMO was associated with lower survival across risk strata.

Conclusions:

• Extracorporeal membrane oxygenation (ECMO) is associated with increased mortality and reduced long-term survival in burn patients.
• Burn-related issues, followed by respiratory and heart failure, were the primary causes of death in the ECMO group.
• This real-world data suggests caution regarding ECMO use in severe burn cases.