Department of Cardiology and Angiology I, Faculty of Medicine, University Heart Center Freiburg, University of Freiburg, Freiburg, Germany.
Faculty of Medicine, Interdisciplinary Medical Intensive Care (IMIT), Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.
Artif Organs. 2022 Dec;46(12):2469-2477. doi: 10.1111/aor.14364. Epub 2022 Jul 22.
The hospital mortality of patients suffering from pulmonary failure requiring venovenous extracorporeal membrane oxygenation (V-V ECMO) or extracorporeal carbon dioxide removal (ECCO R) is high. It is unclear whether outcome correlates with a hospital's annual procedural volume.
Data on all V-V ECMO and ECCO R cases treated from 2007 to 2019 were retrieved from the German Institute for Medical Documentation and Information. Comorbidities and outcomes were assessed by DRG, OPS, and ICD codes. The study population was divided into 5 groups depending on annual hospital V-V ECMO and ECCO R volumes (<10 cases; 10-19 cases; 20-29 cases; 30-49 cases; ≥50 cases). Primary outcome was hospital mortality.
A total of 25 096 V-V ECMO and 3607 ECCO R cases were analyzed. V-V ECMO hospitals increased from 89 in 2007 to 214 in 2019. Hospitals handling <10 cases annually increased especially (64 in 2007 to 149 in 2019). V-V ECMO cases rose from 807 in 2007 to 2597 in 2019. Over 50% of cases were treated in hospitals handling ≥30 cases annually. Hospital mortality was independent of the annual hospital procedural volume (55.3%; 61.3%; 59.8%; 60.2%; 56.3%, respectively, p = 0.287). We detected no differences when comparing hospitals handling <30 cases to those with ≥30 annually (p = 0.659). The numbers of ECCO R hospitals and cases has dropped since 2011 (287 in 2007 to 48 in 2019). No correlation between annual hospital procedural volume and hospital mortality was identified (p = 0.914).
The number of hospitals treating patients requiring V-V ECMO and V-V ECMO cases rose from 2007 to 2019, while ECCO R hospitals and their case numbers decreased. We detected no correlation between annual hospital V-V ECMO or ECCO R volume and hospital mortality.
需要接受静脉-静脉体外膜肺氧合（V-V ECMO）或体外二氧化碳去除（ECCO R）治疗的肺衰竭患者的住院死亡率较高。目前尚不清楚结果是否与医院的年度手术量有关。
从德国医学文献和信息研究所检索了 2007 年至 2019 年期间所有接受 V-V ECMO 和 ECCO R 治疗的病例数据。通过 DRG、OPS 和 ICD 代码评估合并症和结果。根据医院每年 V-V ECMO 和 ECCO R 量，将研究人群分为 5 组（<10 例；10-19 例；20-29 例；30-49 例；≥50 例）。主要结局是住院死亡率。
共分析了 25096 例 V-V ECMO 和 3607 例 ECCO R 病例。2007 年有 89 家 V-V ECMO 医院，2019 年增至 214 家。每年处理<10 例的医院数量尤其增加（2007 年为 64 家，2019 年为 149 家）。2007 年 V-V ECMO 病例数为 807 例，2019 年增至 2597 例。超过 50%的病例在每年处理≥30 例的医院中接受治疗。住院死亡率与医院年度手术量无关（分别为 55.3%、61.3%、59.8%、60.2%和 56.3%，p=0.287）。我们发现处理<30 例和≥30 例的医院之间没有差异（p=0.659）。自 2011 年以来，ECCO R 医院和病例数量有所下降（2007 年为 287 家，2019 年为 48 家）。我们未发现医院年度手术量与住院死亡率之间存在相关性（p=0.914）。
2007 年至 2019 年，需要接受 V-V ECMO 治疗的患者和 V-V ECMO 病例的医院数量有所增加，而 ECCO R 医院及其病例数量则有所减少。我们未发现医院 V-V ECMO 或 ECCO R 年度手术量与住院死亡率之间存在相关性。
