부산대학교 도서관

Background:To guide extracorporeal cardiopulmonary resuscitation (eCPR) use, a generalizable survival prediction model is needed.Methods:We identified patients?18 years with IHCA who received eCPR (January 2000-December 2017) in the AHA Get With The Guidelines?Resuscitation registry to build a survival model. We categorized admission CPC into ?good? (CPC 1) vs other. We singly imputed variables with ?15% missing (admission CPC [20%], duration of event [15%]). Variables associated with death (p-value ?0.1) were retained and initial rhythm was forced into the model. We used firth penalized logistic regression to estimate model parameters. To test the imputation effect, we performed a sensitivity analysis excluding CPC. We performed a Kaplan Meier survival analysis stratified by resuscitation duration (0 to ?15, 15 to ?30, 30 to ?60, ?60 min).Results:Of 1,082 patients who underwent eCPR, 963 were included in the model (Table 1). Area Under the Receiving Operating Characteristic (AUROC) = 0.81 (95% CI [0.78 to 0.83]). Associations with death included: nighttime eCPR use; non-white race; patients with prior renal insufficiency, preceding hypoperfusion, and congestive heart failure. Initial rhythm was not associated with death. Every 10 minutes of resuscitation was associated with 12% increased odds of death. Shorter resuscitation duration was strongly associated with hospital survival (Figure 1). The AUROC was unchanged (0.81 [95% CI 0.78 - 0.84]) after sensitivity analysis excluding CPC.Conclusions:In this preliminary registry analysis, survival after eCPR for IHCA was estimated by patient and arrest characteristics. Our findings require validation.