Long-Term Functional Outcomes in the First 12 Months After VA-ECMO in Adult Patients: A Prospective, Multicenter...

Area of Science:

• Cardiology
• Critical Care Medicine
• Cardiovascular Surgery

Background:

• Long-term outcomes and quality of life are crucial patient-centered outcomes in venoarterial extracorporeal membrane oxygenation (VA-ECMO) research.
• Investigating the incidence of death or new disability at 12 months post-VA-ECMO is essential for understanding patient recovery.

Purpose of the Study:

• To determine the incidence of death or new disability at 12 months following VA-ECMO initiation.
• To analyze changes in functional independence and employment status between 6 and 12 months post-VA-ECMO.

Main Methods:

• A prospective, multicenter, registry-embedded cohort study was conducted across 26 hospitals in Australia and New Zealand.
• Adult patients requiring VA-ECMO were enrolled between February 2019 and April 2023.
• Primary outcomes (death or new disability) were assessed at 6 and 12 months, with adjustments for baseline patient characteristics.

Main Results:

• The incidence of death or new disability at 12 months was 70.6%, similar to 70.8% at 6 months.
• A significant increase in independence in activities of daily living (62.1% vs. 48.2%) and a decrease in unemployment due to health reasons (32.7% vs. 47.4%) were observed at 12 months compared to 6 months.
• Outcomes varied based on the initial reason for VA-ECMO support.

Conclusions:

• Approximately 30% of patients survive VA-ECMO without disability at 12 months, with outcomes influenced by the indication for VA-ECMO.
• The primary burden of disability associated with VA-ECMO appears to emerge within the first 6 months and remains stable between 6 and 12 months post-initiation.