Mortality-related predictors in patients receiving extracorporeal membrane oxygenation after coronary artery bypass grafting: a retrospective study.
- 1Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Erqi District, Zhengzhou, Henan, China.
- 2Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Erqi District, Zhengzhou, Henan, China. [email protected].
- 3Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Erqi District, Zhengzhou, Henan, China. [email protected].
Abstract
Background
This study aimed to evaluate in-hospital mortality and to identify predictors of mortality in coronary artery bypass grafting (CABG) patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support.Methods and results
We retrospectively analysed data from adult patients who received VA-ECMO for cardiogenic shock after CABG at our centre between 2014 and 2025. Among the 10,256 patients who underwent CABG, 74 received ECMO postoperatively. Among these, 33 patients (44.6%) died during ECMO support, 15 patients (20.3%) died after ECMO removal, and 26 patients (35.1%) survived to hospital discharge. For distinguishing hospital mortality, the lactate level at 24 h after ECMO initiation (LAC-T24) (> 4.35 mmol/L, AUROC: 0.916) performed the best, followed by the lactate clearance at 24 h (LC-T24) (< 55.73%, AUROC: 0.915). Other predictive factors included CKMB activity at 24 h (CKMB-T24) (> 157 U/L; AUROC: 0.848), mean arterial pressure at 24 h (MAP-T24) (< 77.5 mmHg; AUROC: 0.844), SOFA-2 scores (> 11.5; AUROC: 0.835), and the pre-ECMO Sequential Organ Failure Assessment scores (SOFA-1) (> 10.5; AUROC: 0.815). The best model revealed the pre-ECMO updated SOFA-2 scores (P < 0.001) (OR: 1.793, 95% CI: 1.029-3.124, P = 0.039), LAC-T24 (OR: 1.395, 95% CI: 1.045-1.861, P = 0.024), CKMB-T24 (OR: 1.015, 95% CI: 1.003-1.026, P = 0.013), and MAP-T24 (OR: 0.895, 95% CI: 0.809-0.989, P = 0.029) as independent predictors of hospital mortality after VA-ECMO.Conclusion
In patients receiving ECMO treatment after CABG, in-hospital mortality rates remains high. In this study, LAC-T24, LC-T24, CKMB-T24, pre-ECMO SOFA-1 and SOFA-2 scores were identified as predictors of mortality.
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BibTeX
@article{zhang2026mortalityrelated,
title = {{Mortality-related predictors in patients receiving extracorporeal membrane oxygenation after coronary artery bypass grafting: a retrospective study.}},
author = {Chi Zhang and Chencan Feng and Peng Zhang and Yabai Kan and Ankang Liu and Xiaohu Li and Jing Wang and Chuang Liu and Guowei Fu and Hui Zhao},
journal = {Journal of cardiothoracic surgery},
year = {2026},
month = jul,
doi = {10.1186/s13019-026-04480-4},
url = {https://europepmc.org/article/MED/42958294},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Mortality-related predictors in patients receiving extracorporeal membrane oxygenation after coronary artery bypass grafting: a retrospective study.
AU - Chi Zhang
AU - Chencan Feng
AU - Peng Zhang
AU - Yabai Kan
AU - Ankang Liu
AU - Xiaohu Li
AU - Jing Wang
AU - Chuang Liu
AU - Guowei Fu
AU - Hui Zhao
PY - 2026
DA - 2026/07/25
JO - Journal of cardiothoracic surgery
DO - 10.1186/s13019-026-04480-4
UR - https://europepmc.org/article/MED/42958294
AB - Background This study aimed to evaluate in-hospital mortality and to identify predictors of mortality in coronary artery bypass grafting (CABG) patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support.Methods and results We retrospectively analysed data from adult patients who received VA-ECMO for cardiogenic shock after CABG at our centre between 2014 and 2025. Among the 10,256 patients who underwent CABG, 74 received ECMO postoperatively. Among these, 33 patients (44.6%) died during ECMO support, 15 patients (20.3%) died after ECMO removal, and 26 patients (35.1%) survived to hospital discharge. For distinguishing hospital mortality, the lactate level at 24 h after ECMO initiation (LAC-T24) (> 4.35 mmol/L, AUROC: 0.916) performed the best, followed by the lactate clearance at 24 h (LC-T24) (< 55.73%, AUROC: 0.915). Other predictive factors included CKMB activity at 24 h (CKMB-T24) (> 157 U/L; AUROC: 0.848), mean arterial pressure at 24 h (MAP-T24) (< 77.5 mmHg; AUROC: 0.844), SOFA-2 scores (> 11.5; AUROC: 0.835), and the pre-ECMO Sequential Organ Failure Assessment scores (SOFA-1) (> 10.5; AUROC: 0.815). The best model revealed the pre-ECMO updated SOFA-2 scores (P < 0.001) (OR: 1.793, 95% CI: 1.029-3.124, P = 0.039), LAC-T24 (OR: 1.395, 95% CI: 1.045-1.861, P = 0.024), CKMB-T24 (OR: 1.015, 95% CI: 1.003-1.026, P = 0.013), and MAP-T24 (OR: 0.895, 95% CI: 0.809-0.989, P = 0.029) as independent predictors of hospital mortality after VA-ECMO.Conclusion In patients receiving ECMO treatment after CABG, in-hospital mortality rates remains high. In this study, LAC-T24, LC-T24, CKMB-T24, pre-ECMO SOFA-1 and SOFA-2 scores were identified as predictors of mortality.
SN - 1749-8090
ER -