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日本接受体外膜肺氧合治疗的新冠肺炎患者状况:全国数据库分析

Status of COVID-19 Patients Treated With Extracorporeal Membrane Oxygenation in Japan: Nationwide Database Analysis.

作者信息

Kuribara Tomoki, Asai Yusuke, Ohmagari Norio, Yokota Isao

机构信息

Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, JPN.

Acute and Critical Care Nursing, School of Nursing, Sapporo City University, Sapporo, JPN.

出版信息

Cureus. 2024 May 13;16(5):e60202. doi: 10.7759/cureus.60202. eCollection 2024 May.

Abstract

Background The report of epidemiological data on coronavirus disease 2019 (COVID-19) patients treated using extracorporeal membrane oxygenation (ECMO) in Japan has been limited. Our study seeks to fill the existing gap in knowledge by providing an in-depth analysis of the clinical epidemiological characteristics and diverse medical outcomes of COVID-19 patients treated with ECMO in Japan. Methods This study used the COVID-19 Registry Japan nationwide database. We included patients aged 18 years or older enrolled between March 17, 2020, and February 1, 2022, with traceable ECMO data. The items on clinical epidemiological characteristics and various medical outcomes were collected. Statistical analysis included a median and interquartile range (IQR) for continuous variables and frequencies for categorical variables. Results The number of participating hospitals was 731, and the number of patients enrolled for analysis was 49,590. Of these, 196 (0.4%) patients received ECMO. Hospital mortality was 33.2%, and discharge to home was 23.0% in the ECMO group. The complications during hospitalization included pneumothorax (9.7%), seizures (4.1%), stroke (4.6%), and pulmonary thromboembolism (2.0%). At discharge, 38.3% had worsened self-care ability, and 38.8% had worsened ambulatory function. Conclusions The results of ECMO treatment in Japan showed that the mortality and complication rates were well-controlled compared with those worldwide.

摘要

背景

关于日本使用体外膜肺氧合(ECMO)治疗2019冠状病毒病(COVID-19)患者的流行病学数据报告有限。我们的研究旨在通过深入分析日本接受ECMO治疗的COVID-19患者的临床流行病学特征和多样的医疗结局,填补现有知识空白。方法:本研究使用了日本全国COVID-19注册数据库。我们纳入了2020年3月17日至2022年2月1日期间登记的18岁及以上且有可追溯ECMO数据的患者。收集了临床流行病学特征和各种医疗结局的项目。统计分析包括连续变量的中位数和四分位数间距(IQR)以及分类变量的频率。结果:参与医院数量为731家,纳入分析的患者数量为49,590人。其中,196名(0.4%)患者接受了ECMO治疗。ECMO组的医院死亡率为33.2%,出院回家率为23.0%。住院期间的并发症包括气胸(9.7%)、癫痫发作(4.1%)、中风(4.6%)和肺血栓栓塞(2.0%)。出院时,38.3%的患者自我护理能力恶化,38.8%的患者步行功能恶化。结论:日本ECMO治疗的结果表明,与全球相比,死亡率和并发症发生率得到了良好控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d39f/11168340/94470f426ca4/cureus-0016-00000060202-i01.jpg

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