中国体外生命支持2025，Vol.23Issue(5)：399-404,409,7.DOI:10.13498/j.cnki.chin.j.ecls.2025.05.05
心脏术后患者应用体外膜氧合预后危险因素分析及模型初步构建
Prognostic Risk Factors Analysis and Predictive Model Construction for Patients Receiving Extracorporeal Membrane Oxygenation After Cardiac Surgery
摘要
Abstract
Objective To identify prognostic risk factors and construct a predictive model for weaning outcomes in cardiac surgery patients receiving postoperative extracorporeal membrane oxygenation(ECMO).Methods A retrospective co-hort study included 65 patients who underwent cardiac surgery and received ECMO treatment after surgery in our hospital from October 2019 to September 2024.According to the weaning situation,they were divided into the success group(n=43)and the failure group(n=22).Comparative analyses of baseline characteristics,hemodynamics parameters,and laboratory indexes were performed.Independent risk factors were identified via multivariate logistic regression,and predictive performance was evalu-ated using receiver operating characteristic(ROC)curves.Results After treatment,significant improvements were observed in heart rate(HR),central venous pressure,troponin I(TnI),creatine kinase isoenzyme-MB,lactate,serum creatinine,total bili-rubin and aspartate aminotransferase were significantly decreased(P<0.05),alongside increased mean arterial pressure and left ventricular ejection fraction were significantly increased(P<0.05).The APACHE II score,ECMO duration and the incidence of severe hemorrhage in the successful group were significantly lower than those in the failure group(P<0.05).The HR,TnI and lactare in the successful group were significantly lower than those in the failure group(P<0.05).Multivariate analysis showed identified elevated HR(OR=4.544),high TnI(OR=41.918)and high lactate levels(OR=14.073)were independent risk factors for weaning failure(P<0.05).ROC analysis demonstrated robust predictive performance for these variables,with areas under the curve(AUC)of 0.878(95%CI:0.796-0.961),0.951(95%CI:0.879-1.000),and 0.858(95%CI:0.770-0.946)respectively.Conclusion ECMO effectively improve cardiac function of patients after cardiac surgery,and higher HR,TnI,and blood lactate levels are independent risk factors for ECMO weaning failure in patients after cardiac surgery.关键词
体外膜氧合/心脏手术/预后/危险因素/构建模型Key words
extracorporeal membrane oxygenation/cardiac operation/prognosis/risk factors/build the model引用本文复制引用
黄真珍,翟蒙恩,杨剑,蒋书云..心脏术后患者应用体外膜氧合预后危险因素分析及模型初步构建[J].中国体外生命支持,2025,23(5):399-404,409,7.基金项目
陕西省重点研发计划(2024SF-YBXM-428) （2024SF-YBXM-428）
