Evidence map›Paper›PMID 26562346›Full record

ArticleCritical care medicine2016

Urinary Output Predicts Survival in Patients Undergoing Extracorporeal Membrane Oxygenation Following Cardiovascular Surgery.

Klaus Distelmaier, Christian Roth, Christina Binder, Lore Schrutka, Catharina Schreiber, Friedrich Hoffelner, Gottfried Heinz, Irene M Lang, Gerald Maurer, Herbert Koinig and 3 more

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In one paragraph

Article in Critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Pooled it
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  4. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 1 institution in 2 countries.

Klaus Distelmaier1Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.2Department of Cardiac Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.3Department of Cardiac Surgery, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.4Department of Anaesthesia and Intensive Care Medicine, Karl Landsteiner University of Health Sciences, University Hospital Krems, Krems an der Donau, Austria.5Department of Cardiotharacic and Vascular Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria.
Christian Roth
Christina Binder
Lore Schrutka
Catharina Schreiber
Friedrich Hoffelner
Gottfried Heinz
Irene M Lang
Gerald Maurer
Herbert Koinig
Barbara Steinlechner
Alexander Niessner
Georg Goliasch
Apple (Israel) · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesExtracorporeal membrane oxygenation represents a valuable and rapidly evolving therapeutic option in patients with severe heart or lung failure following cardiovascular surgery. However, survival remains poor and accurate risk stratification challenging. Therefore, we evaluated the predictive value of urinary output within 24 hours after extracorporeal membrane oxygenation initiation on mortality in patients undergoing venoarterial extracorporeal membrane oxygenation support following cardiovascular surgery and aimed to improve established risk prediction models.

designSingle-center, observational registry.

settingUniversity-affiliated tertiary care center. PATIENTS: We included 205 patients undergoing veno-arterial extracorporeal membrane oxygenation therapy following cardiovascular surgery at a university-affiliated tertiary-care center into our single-centre registry.

interventionsNone. MEASUREMENTS AND MAIN

resultsDuring a median follow-up time of 35 months (interquartile range, 19-69), 64% of patients died. Twenty-four-hour urinary output was the strongest predictor of outcome among renal function variables with an adjusted hazard ratio per 1 SD of 0.55 (95% CI, 0.40-0.76; p < 0.001) for 30-day mortality and of 0.65 (95% CI, 0.53-0.86; p = 0.002) for 2-year long-term mortality. Most remarkably, 24-hour urinary output showed additional prognostic value beyond that achievable with the simplified acute physiology score-3 and sequential organ failure assessment score indicated by improvements in the category-free net reclassification index for 30-day mortality (simplified acute physiology score-3: 36%, p = 0.015; sequential organ failure assessment score: 36%, p = 0.02), as well as for 2-year mortality (simplified acute physiology score-3: 33%, p = 0.02; sequential organ failure assessment score: 43%, p = 0.005).

conclusionsWe identified 24-hour urinary output as a strong and easily available predictor of mortality in patients undergoing extracorporeal membrane oxygenation therapy following cardiovascular surgery. Implementation of 24-hour urinary output leads to a substantial improvement of established risk prediction models in this vulnerable patient population. These results are particularly compelling because measurement of urinary output is inexpensive and routinely performed in all critical care units.

Indexed as

Cardiovascular Surgical ProceduresUrineAdultAgedExtracorporeal Membrane OxygenationFemaleFollow-Up StudiesHumansIntensive Care UnitsMaleMiddle AgedOrgan Dysfunction ScoresPrognosisRespiratory Insufficiency

Identifiers

PMID26562346
OpenAlexW2314453939

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.