• Silvia Mariani, Justine Mafalda Ravaux, Bas C T van Bussel, Maria Elena De Piero, Sander M J van Kruijk, Anne-Kristin Schaefer, Dominik Wiedemann, Diyar Saeed, Matteo Pozzi, Antonio Loforte, Udo Boeken, Robertas Samalavicius, Karl Bounader, Xiaotong Hou, BungeJeroen J HJJHDepartment of Intensive Care Adults, Erasmus MC, Rotterdam, The Netherlands; Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands., Hergen Buscher, Leonardo Salazar, Bart Meyns, Michael A Mazzeffi, Sacha Matteucci, Sandro Sponga, Vitaly Sorokin, Claudio Russo, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Daniele Camboni, Giuseppe Maria Raffa, Rodrigo Diaz, I-Wen Wang, Jae-Seung Jung, Jan Belohlavek, Vin Pellegrino, Giacomo Bianchi, Matteo Pettinari, Alessandro Barbone, José P Garcia, Kiran Shekar, WhitmanGlenn J RGJRDivision of Cardiac Surgery, Department of Surgery, Heart and Vascular Institute, Johns Hopkins University School of Medicine, Baltimore, Md., Roberto Lorusso, and PELS Investigators.
• Cardiovascular Research Institute Maastricht, University of Maastricht, Maastricht, The Netherlands; Cardiac Surgery Unit, Cardio-Thoracic and Vascular Department, Fondazione IRCCS San Gerardo, Monza, Italy. Electronic address: s.mariani1985@gmail.com.
• J. Thorac. Cardiovasc. Surg. 2024 Dec 1; 168 (6): 17011711.e301701-1711.e30.

ObjectivesAlthough cardiogenic shock requiring extracorporeal life support after cardiac surgery is associated with high mortality, the impact of sex on outcomes of postcardiotomy extracorporeal life support remains unclear with conflicting results in the literature. We compare patient characteristics, in-hospital outcomes, and overall survival between females and males requiring postcardiotomy extracorporeal life support.MethodsThis retrospective, multicenter (34 centers), observational study included adults requiring postcardiotomy extracorporeal life support between 2000 and 2020. Preoperative, procedural, and extracorporeal life support characteristics, complications, and survival were compared between females and males. Association between sex and in-hospital survival was investigated through mixed Cox proportional hazard models.ResultsThis analysis included 1823 patients (female: 40.8%; median age: 66.0 years [interquartile range, 56.2-73.0 years]). Females underwent more mitral valve surgery (females: 38.4%, males: 33.1%, P = .019) and tricuspid valve surgery (feamales: 18%, males: 12.4%, P < .001), whereas males underwent more coronary artery surgery (females: 45.9%, males: 52.4%, P = .007). Extracorporeal life support implantation was more common intraoperatively in feamales (females: 64.1%, females: 59.1%) and postoperatively in males (females: 35.9%, males: 40.9%, P = .036). Ventricular unloading (females: 25.1%, males: 36.2%, P < .001) and intra-aortic balloon pumps (females: 25.8%, males: 36.8%, P < .001) were most frequently used in males. Females had more postoperative right ventricular failure (females: 24.1%, males: 19.1%, P = .016) and limb ischemia (females: 12.3%, males: 8.8%, P = .23). In-hospital mortality was 64.9% in females and 61.9% in males (P = .199) with no differences in 5-year survival (females: 20%, 95% CI, 17-23; males: 24%, 95% CI, 21-28; P = .069). Crude hazard ratio for in-hospital mortality in females was 1.12 (95% CI, 0.99-1.27; P = .069) and did not change after adjustments.ConclusionsThis study demonstrates that female and male patients requiring postcardiotomy extracorporeal life support have different preoperative and extracorporeal life support characteristics, as well as complications, without a statistical difference in in-hospital and 5-year survivals.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

34 keywords...

hide…