Acute cardiac care & resuscitationCohort study
Prognostic implications of complications during VA-ECMO for cardiogenic shock
- Registry analysis using Cox proportional hazards analysis, Multi-State Model (MSM) analysis and landmark Kaplan Meier survival analysis
- Extracorporeal Life Support Organization (ELSO) Registry
- complications as time-dependent covariates
- 2017-2024
Authors' conclusion
Complications on VA-ECMO have a significant and cumulative effect on in-hospital mortality, with a higher number associated with increased risk of death. Neurologic and pulmonary complications were associated with the greatest mortality risk.
Study context
- Population
- Adults with a diagnosis of cardiogenic shock (CS) treated with VA-ECMO31.7% female
- Participants
- 22,547 adults
- Exposure
- Association between timing and type of complication and in-hospital mortality
- Non-survivorsn = 12,094
Main finding
As reported in the abstract
In-hospital mortality · index hospitalization
Died during index hospitalization
12,094 (54%)
Observational data: associations, not effects.
Further findings
Patients experiencing complications
Patients experiencing complications
- All sub-types occurring more frequently in non-survivors
Hazard of mortality with neurologic complications
- Neurologic complications increased the hazard of mortality by
- 3.6 (95% C.I 3.4 - 3.8)
- Cox proportional hazards analysis, complications as time-dependent covariates
Absolute 30-day risk of mortality
- 0 complications
- 48.6%
- Neurologic complication
- 93.1%
- MSM analysis
Conditional survival given survival to 3 weeks
- Patients without complications within the first 3 weeks had the highest conditional survival
- Landmark survival analysis
Original publication
Prognostic implications of complications during VA-ECMO for cardiogenic shock. Eur Heart J Acute Cardiovasc Care. Published 6 October 2026. doi:10.1093/ehjacc/zuag127
Summarised from the published abstract; every number is checked against it