• Fausto Biancari, Magnus Dalén, Antonio Fiore, Angelo M Dell'Aquila, Kristján Jónsson, Sigurdur Ragnarsson, Giuseppe Gatti, Marco Gabrielli, Svante Zipfel, Vito G Ruggieri, Andrea Perrotti, Karl Bounader, Khalid Alkhamees, Antonio Loforte, Andrea Lechiancole, Marek Pol, Matteo Pettinari, Dieter De Keyzer, Antti Vento, Henryk Welp, Thomas Fux, Hakeem Yusuff, Daniele Maselli, Tatu Juvonen, and Giovanni Mariscalco.
• Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Research Unit of Surgery, Anesthesiology and Critical Care, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Surgery, University of Turku, Turku, Finland.
• J. Cardiothorac. Vasc. Anesth. 2022 Jun 1; 36 (6): 1678-1685.

ObjectiveThere is a paucity of sex-specific data on patients' postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO). The present study sought to assess this issue in a multicenter study.DesignRetrospective, propensity score-matched analysis of an international registry.SettingMulticenter study, tertiary university hospitals.ParticipantsData on adult patients undergoing postcardiotomy VA-ECMO.Measurements And Main ResultsBetween January 2010 and March 2018, patients treated with postcardiotomy VA-ECMO at 17 cardiac surgery centers were analyzed. Index procedures considered were coronary artery bypass graft surgery, isolated valve surgery, their combination, and proximal aortic root surgery. Hospital and five-year mortality constituted the endpoints of interest. Propensity score matching was adopted with logistic regression. A total of 358 patients (mean age: 63.3 ± 12.3 years; 29.6% female) were identified. Among 94 propensity score-matched pairs, women had a higher hospital mortality (70.5% v 56.4%, p = 0.049) compared with men. Logistic regression analysis showed that women (odds ratio [OR], 1.87; 95% confidence interval [CI] 1.10-3.16), age (OR, 1.06; 95%CI 1.04-1.08) and pre-ECMO arterial lactate (OR, 1.09; 95%CI 1.04-1.16) were independent predictors of hospital mortality. No differences between female and male patients were observed for other outcomes. Among propensity score-matched pairs, one-, three-, and five-year mortality were 60.6%, 65.0%, and 65.0% among men, and 71.3%, 71.3%, and 74.0% among women, respectively (p = 0.110, adjusted hazard ratio, 1.27; 95%CI 0.96-1.66).ConclusionsIn postcardiotomy VA-ECMO, female patients demonstrated higher hospital mortality than men. Morbidity and late mortality were similar between the two groups.Copyright © 2021 Elsevier Inc. All rights reserved.

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