• Arch Med Sci · Jan 2023

    Gastrointestinal haemorrhage in extracorporeal membrane oxygenation: insights from the national inpatient sample.

    • Shantanu Solanki, Khwaja Fahad Haq, George Jolly, Raja Chandra Chakinala, Muhammad Ali Khan, Neil R Patel, Abhishek Bhurwal, Khwaja Saad Haq, Christopher Nabors, Sarju Ganatra, and Wilbert Aronow.
    • Department of Medicine, Geisinger Commonwealth School of Medicine, Scranton, PA, United States.
    • Arch Med Sci. 2023 Jan 1; 19 (3): 600607600-607.

    IntroductionExtracorporeal membrane oxygenation (ECMO) is associated with gastrointestinal haemorrhage (GIH), which may result from coagulopathy, systemic inflammation, reduced gastric perfusion, and arteriovenous malformation from non-pulsatile blood flow. Data are limited regarding the burden of this complication in the United States.Material And MethodsWe analysed the National Inpatient Sample (NIS) database for the years 2007 to 2011 to identify hospitalisations in which an ECMO procedure was performed. Hospitalizations complicated by GIH in this cohort were then identified by relevant codes.ResultsBetween 2007 and 2011, ECMO hospitalisations increased from 1869 to 3799 (p < 0.01). The proportion of hospitalisations complicated by GIH increased from 2.12% in 2007 to 7.46% in 2011 (p < 0.01). Gastrointestinal haemorrhage was more common in men (56.7%) and in Caucasians (57.4%). Common comorbidities in this population were renal failure (71%), anaemia (55%), and hypertension (26%). All-cause inpatient mortality showed a numerical but nonsignificant increase from 56.7% to 61.9% (p = 0.49). The average cost of care per hospitalisation with GIH associated with ECMO use increased from $132,420 in 2007 to $215,673 in 2011 (p < 0.01).ConclusionsGastrointestinal haemorrhage during ECMO hospitalisations occurred in small but significantly increasing proportions. The inpatient mortality rate and costs associated with GIH were substantial and increased significantly during the study period.Copyright: © 2021 Termedia & Banach.

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