Factors Associated with In-Hospital Mortality Among Adults Receiving ECMO: A Nationwide Cohort Study (2011-2020)

Area of Science:

• Critical Care Medicine
• Cardiovascular Medicine
• Respiratory Medicine

Background:

• Extracorporeal membrane oxygenation (ECMO) use is increasing globally.
• High in-hospital mortality persists among adult ECMO recipients.
• Limited large-scale data exists on factors influencing ECMO mortality in real-world settings.

Purpose of the Study:

• To determine in-hospital mortality rates for adult ECMO patients in Taiwan.
• To identify patient- and treatment-related factors associated with ECMO mortality.
• To provide insights for ECMO care planning and risk communication.

Main Methods:

• Retrospective nationwide cohort study using Taiwan's National Health Insurance Research Database (2011-2020).
• Inclusion of adult patients (≥18 years) receiving ECMO.
• Multivariable logistic regression to analyze factors associated with in-hospital mortality.

Main Results:

• 15,151 adults received ECMO; 63.7% died during hospitalization.
• Increased mortality linked to older age, high comorbidity burden (CCI ≥3), and multiple ECMO machines (≥2).
• Cardiogenic shock indications showed lower adjusted mortality odds; longer hospital stay inversely correlated with mortality.

Conclusions:

• Adult ECMO recipients face high in-hospital mortality.
• Mortality risk is influenced by age, comorbidities, treatment complexity, and specific indications.
• Findings offer population-level insights for ECMO care management and risk assessment.