Background
Obesity is known to impact outcomes of patients undergoing in-patient care in general.
The association between veno-arterial extracorporeal membrane oxygenation (VA ECMO)
and obesity-related outcomes remains unclear. Therefore, we sought to investigate
weight-associated differences of patients treated with VA ECMO.
Method
A retrospective study was performed for patients who required veno-arterial (VA) ECMO
support at our tertiary ECMO centre between 1 March 2006 and 28 February 2017. Patients
were categorised according to Body-Mass-Index (BMI) associated values in six groups
(underweight, normal range, overweight, obese class I-III). Further, patients were
divided into non-obese (18.5-29-9 kg/m2) and obese (≥30 kg/m2) groups and analysed concerning baseline, ECMO-related, and general outcome parameters.
Results
A total of 244 patients required VA ECMO support during the study period. Subgroup-analysis
of BMI-category associated impact on in-hospital mortality showed the highest incidence
of mortality in obese class II patients (93%) with a significant difference between
overweighted patients. Non-obesity was present in 179, whereas 59 patients suffered
obesity. Obese patients were significantly older (p=0.022) and suffered significantly
more diabetes (21% non-obese vs 48% obese; p<0.001). Indication for support, laboratory
parameters prior to ECMO, and ECMO-related outcomes did not differ between the groups.
Obese patients showed a trend towards higher in-hospital mortality (70% non-obese
vs 81% obese; p=0.085).
Conclusions
Obesity is associated with comparable outcomes to non-obese patients, showing a tendency
of higher mortality. Obese class II patients presented the highest risk of death compared
to all BMI categories.
Keywords
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Article info
Publication history
Published online: August 01, 2022
Accepted:
March 14,
2022
Received in revised form:
March 6,
2022
Received:
January 5,
2022
Identification
Copyright
© 2022 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
