ECMO survivors suffer from long-term functional impairments
While patients on extracorporeal membrane oxygenation (ECMO) appear to enjoy good survival rates, long-term quality of life (QoL) and functional deficits still persist, a recent study has found.
The study included 77 ECMO patients (median age, 43 years; 59.7 percent male), in whom the Short Form 36 version 2 (SF36v2) was used to assess health-related QoL.
Majority of the participants (62 percent; n=48) survived to hospital discharge, of whom 42 percent and 58 percent had received venoarterial (VA) and venovenous (VV) ECMO, respectively. Actuarial survival rate at 1 and 3 years was 0.61 (0.41 for VA ECMO and 0.88 for VV ECMO patients). There were no deaths after discharge from the ICU.
After 12 months of follow-up, the mean physical and mental component summary scores in the overall cohort were 46.4±9.9 and 48.7±13.3 years, respectively. Relative to age-matched general population cohorts, ECMO patients showed significantly worse functional outcome scores. Mean score in the Physical Function domain of the SF36v2, for instance, was 65.0±28.5 in survivors, significantly lower than the age-adjusted norms (87.4±6.8; mean difference [MD], –22.4, 95 percent CI, –33.2 to –11.6; p<0.001).
The same was true for the Role Physical (MD, –18.5, –29.4 to –7.6; p=0.002), General Health (MD, –13.8, –22.7 to –4.9; p=0.003), Social Functioning (MD, –11.2, –22.0 to –0.5; p=0.041), Role Emotional (MD, –11.3, –21.8 to –0.8; p=0.036) and Mental Health (MD, –9.0, –18.3 to 0.33; p=0.058) domains.
A return-to-work survey was also administered, revealing that from 61 percent (n=33) of the participants who were employed before ECMO, the proportion of workers dropped to 58 percent (n=19) of the total sample. More than half (52 percent; n=17) were engaged in a form of social or recreational activity.