Your browser doesn't support javascript.
Evaluation of the discrimination and calibration of predictive scores of mortality in ECMO for patients with COVID-19.
Huespe, Ivan Alfredo; Lockhart, Carolina; Kashyap, Rahul; Palizas, Fernando; Colombo, Malena; Romero, Maria Del Pilar; Prado, Eduardo; Casabella García, Christian A; Las Heras, Marcos; Carboni Bisso, Indalecio.
  • Huespe IA; Unidad de Terapia Intensiva Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Lockhart C; Área de investigación en medicina Interna, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Kashyap R; Universidad de Buenos Aires, Buenos Aires, Argentina.
  • Palizas F; Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, Massachusetts, USA.
  • Colombo M; Unidad de Terapia Intensiva Adultos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
  • Romero MDP; Global Clinical Scholars Research Trainee, Harvard Medical School, Boston, Massachusetts, USA.
  • Prado E; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Casabella García CA; Department of Research, WellSpan Health, York, Pennsylvania, USA.
  • Las Heras M; Unidad de Terapia Intensiva Adultos, Clínica Bazterrica, Buenos Aires, Argentina.
  • Carboni Bisso I; Instituto Universitario del Hospital Italiano, Buenos Aires, Argentina.
Artif Organs ; 47(6): 1007-1017, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-2192358
ABSTRACT

BACKGROUND:

The criteria for the selection of COVID-19 patients that could benefit most from ECMO organ support are yet to be defined. In this study, we evaluated the predictive performance of ECMO mortality predictive models in patients with COVID-19. We also performed a cost-benefit analysis depending on the mortality predicted probability. We conducted a retrospective cohort study in COVID-19 patients who received ECMO at two tertiary care hospitals between March 2020 to July 2021. MATERIALS AND

METHODS:

We evaluated the discrimination (C-statistic), calibration (Cox calibration), and accuracy of the prediction of death due to severe ARDS in V-V ECMO score (PRESERVE), the Respiratory Extracorporeal Membrane Oxygenation Survival Score (RESP) score, and the PREdiction of Survival on ECMO Therapy-Score (PRESET) score. In addition, we compared the RESP score with Plateau pressure instead of Peak pressure.

RESULTS:

We included a total of 36 patients, 29 (80%) of them male and with a median (IQR) APACHE of 10 (8-15). The PRESET score had the highest discrimination (AUROCs 0.81 [95%CI 0.67-0.94]) and calibration (calibration-in-the-large 0.5 [95%CI -1.4 to 0.3]; calibration slope 2.2 [95%CI 0.7/3.7]). The RESP score with Plateau pressure had higher discrimination than the conventional RESP score. The cost per QALY in the USA, adjusted to life expectancy, was higher than USD 100 000 in patients older than 45 years with a PRESET > 10.

CONCLUSION:

The PRESET score had the highest predictive performance and could help in the selection of patients that benefit most from this resource-demanding and highly invasive organ support.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Artif Organs Year: 2023 Document Type: Article Affiliation country: Aor.14493

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Extracorporeal Membrane Oxygenation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Artif Organs Year: 2023 Document Type: Article Affiliation country: Aor.14493