Clinical Research Details

Descriptive Information
Extracorporeal Membrane Oxygenation Use and Predictors of Mortality in Adult Patients with Cardiogenic Shock in Hospitals in the United States

Mazen El Sayed

This study is exempted
Completed- Has Results


Rana Bachir
Conditions and Keywords
ECMO,Cardiogenic Shock
Nationwide Emergency Department Sample Setting (NEDS) ,retrospective ,Large dataset
Study Design
Basic / Translational
N/A: Not Applicable
N/A: Not Applicable
N/A: Not Applicable
N/A: Not Applicable
Eligibility and IRB

    Despite several observational and registry studies on ECMO use, few studies describe the extent of ECMO use in patients with cardiogenic shock. This study examines ECMO use and identifies predictors of mortality in patients treated for cardiogenic shock in a sample of US hospitals.

  • Design: This was an analytical, retrospective observational study.
  • Setting: The study used the US Nationwide Emergency Department Sample Setting (NEDS) database of 2013.
  • Participants: Weighted visits for cardiogenic shock (discharge diagnosis) with ECMO use were included.
  • Interventions: None
  • Main outcome measures: The primary outcome of interest was in hospital mortality. Secondary outcome of interest was average length of stay.

    The 2013 NEDS dataset contains information on weighted 134,869,015 ED visits. Out of the total weighted ED visits, 8,550,450 were adult visits to the ED for cardiogenic shock, and of those, 992 adults (18 years or older) underwent an ECMO procedure. Only patients who died in the ED or were admitted to the same hospital were included in the study (total of 992 patients).

    NEDS is a product of Healthcare Cost and Utilization Project (HCUP) under the auspices of the Agency for Healthcare Research and Quality (AHRQ). It is the largest U.S. all-payer ED database, combining medical and non-clinical data from both national and state sources. This database is defined as limited data set under the HIPAA Privacy Rule and as such is de-identified prior to use. As per requirements for publishing HCUP data and to safeguard patients’ privacy, data on any variable with size less than or equal to 10 are excluded.
    Data from this stratified sample is accrued from 945 hospital-owned EDs located across 33 States and the District of Columbia, reflecting approximately 20% of all hospital-based EDs located in the United States. The following stratification variables were used to weight data according to HCUP specifications: U.S. Census region, urban-rural location, ownership, and teaching status of the hospital and trauma center designation.

Only patients who died in the ED or were admitted to the same hospital were included in the study (total of 992 patients).

Patients who were transferred to other hospitals or died before admission to the ED were excluded