A predictive model for intracranial hemorrhage in adult patients receiving extracorporeal membrane oxygenation  

作　　者：Yi Zhu Lina Mao Zhongman Zhang Sae Rom Lee Tianshi Li Hao Zhou Yanbin Dong Di An Wei Li Xufeng Chen 

机构地区：[1]Department of Emergency and Critical Care Medicine,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China [2]Department of Emergency Center,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China

出　　处：《World Journal of Emergency Medicine》2025年第2期153-160,共8页世界急诊医学杂志(英文)

基　　金：supported by the National Natural Science Foundation of China (82072159)。

摘　　要：BACKGROUND:Intracranial hemorrhage (ICH),a severe complication among adults receiving extracorporeal membrane oxygenation (ECMO),is often related to poor outcomes.This study aimed to establish a predictive model for ICH in adults receiving ECMO treatment.METHODS:Adults who received ECMO between January 2017 and June 2022 were the subjects of a single-center retrospective study.Patients under the age of 18 years old,with acute ICH before ECMO,with less than 24 h of ECMO support,and with incomplete data were excluded.ICH was diagnosed by a head computed tomography scan.The outcomes included the incidence of ICH,in-hosptial mortality and 28-day mortality.Multivariate logistic regression analysis was used to identify relevant risk factors of ICH,and a predictive model of ICH with a nomogram was constructed.RESULTS:Among the 227 patients included,22 developed ICH during ECMO.Patients with ICH had higher in-hospital mortality (90.9%vs.47.8%,P=0.001) and higher 28-day mortality (81.8%vs.47.3%,P=0.001) than patients with non-ICH.ICH was associated with decreased grey-white-matter ratio (GWR)(OR=0.894,95%CI:0.841–0.951,P<0.001),stroke history (OR=4.265,95%CI:1.052–17.291,P=0.042),fresh frozen plasma (FFP) transfusion (OR=1.208,95%CI:1.037–1.408,P=0.015)and minimum platelet (PLT) count during ECMO support (OR=0.977,95%CI:0.958–0.996,P=0.019).The area under the receiver operating characteristic curve of the ICH predictive model was 0.843 (95%CI:0.762–0.924,P<0.001).CONCLUSION:ECMO-treated patients with ICH had a higher risk of death.GWR,stroke history,FFP transfusion,and the minimum PLT count were independently associated with ICH,and the ICH predictive model showed that these parameters performed well as diagnostic tools.

关 键 词：Extracorporeal membrane oxygenation Intracranial hemorrhage Predictive model Grey-white-matter ratio 

分 类 号：R743.34[医药卫生—神经病学与精神病学]