CLINICAL OUTCOMES AND HEALTHCARE RESOURCE UTILIZATION AMONG PATIENTS RECEIVING EXTRACORPOREAL MEMBRANE OXYGENATION IN HUNAN PROVINCE, 2021-2024: A RETROSPECTIVE STUDY
Author(s)
Xinhua Ma, PhD, MD1, Li Li, PhD, MD1, Qianyi Peng, MD1, Dan Yu, MSC1, Zhaoxin Qian, PhD1, Yang Tang, MD2, Zhixin Zhang, MD2, Yi Chen, MD2, Wendong Chen, PhD, MD1;
1Xiangya Hospital, Central South University, Changsha, China, 2Changsha Normin Health Technology Ltd, Changsha, China
1Xiangya Hospital, Central South University, Changsha, China, 2Changsha Normin Health Technology Ltd, Changsha, China
OBJECTIVES: To describe the real-world utilization of extracorporeal membrane oxygenation (ECMO) in Hunan Province from 2021 to 2024 and to compare patient characteristics, clinical outcomes, healthcare resource utilization, and prognostic factors between venous-arterial (VA) and venous-venous (VV) ECMO.
METHODS: This retrospective cohort study included adult patients receiving ECMO support in Hunan Province between January 2021 and December 2024. Data were extracted from the provincial hospital discharge database and intensive care quality control registry. VA-ECMO and VV-ECMO patient cohorts were analyzed separately. Multivariable Cox proportional hazards models were used to identify factors associated with in-hospital mortality and successful ECMO weaning.
RESULTS: Of included 775 patients, 530 received VA-ECMO and 245 received VV-ECMO. Cardiovascular diseases were the main indications for VA-ECMO, while severe pneumonia and infection-related respiratory failure predominated in VV-ECMO. In-hospital survival and ECMO weaning success rates were 39.6% and 43.2% in VA-ECMO cohort, and 33.1% and 38.0% in VV-ECMO cohort, respectively. Cardiogenic shock was independently and significantly associated with increased in-hospital mortality in VA-ECMO patients (hazard ratio [HR] = 2.47, 95% confidence interval [CI]: 1.67-3.64). In VV-ECMO patients, severe pneumonia (HR = 6.79, 95% CI: 1.68-27.47) and septic shock (HR = 5.78, 95% CI: 1.23-27.12) were significantly associated with higher mortality, while older age was negatively and significantly associated with successful weaning (HR = 0.97, 95% CI: 0.96-0.99). Median length of hospital stay was 9.0 days for patients receiving VA-ECMO and 19.0 days for patients receiving VV-ECMO.
CONCLUSIONS: Patients receiving VA-ECMO and VV-ECMO in Hunan Province, China show marked heterogeneity in indications, outcomes, and resource utilization. Clinical outcomes are largely driven by underlying disease severity and infectious burden, underscoring the importance of indication-specific ECMO management and optimized regional resource allocation.
METHODS: This retrospective cohort study included adult patients receiving ECMO support in Hunan Province between January 2021 and December 2024. Data were extracted from the provincial hospital discharge database and intensive care quality control registry. VA-ECMO and VV-ECMO patient cohorts were analyzed separately. Multivariable Cox proportional hazards models were used to identify factors associated with in-hospital mortality and successful ECMO weaning.
RESULTS: Of included 775 patients, 530 received VA-ECMO and 245 received VV-ECMO. Cardiovascular diseases were the main indications for VA-ECMO, while severe pneumonia and infection-related respiratory failure predominated in VV-ECMO. In-hospital survival and ECMO weaning success rates were 39.6% and 43.2% in VA-ECMO cohort, and 33.1% and 38.0% in VV-ECMO cohort, respectively. Cardiogenic shock was independently and significantly associated with increased in-hospital mortality in VA-ECMO patients (hazard ratio [HR] = 2.47, 95% confidence interval [CI]: 1.67-3.64). In VV-ECMO patients, severe pneumonia (HR = 6.79, 95% CI: 1.68-27.47) and septic shock (HR = 5.78, 95% CI: 1.23-27.12) were significantly associated with higher mortality, while older age was negatively and significantly associated with successful weaning (HR = 0.97, 95% CI: 0.96-0.99). Median length of hospital stay was 9.0 days for patients receiving VA-ECMO and 19.0 days for patients receiving VV-ECMO.
CONCLUSIONS: Patients receiving VA-ECMO and VV-ECMO in Hunan Province, China show marked heterogeneity in indications, outcomes, and resource utilization. Clinical outcomes are largely driven by underlying disease severity and infectious burden, underscoring the importance of indication-specific ECMO management and optimized regional resource allocation.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO37
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)