ArticleESC heart failure2024
Acute kidney injury and cardiogenic shock severity for mortality risk stratification in patients supported with VA ECMO.
Article in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Kidney Failure in Cardiogenic Shock.Circulation. Heart failure · 2026Review
- Renal replacement therapy in patients under extracorporeal membrane oxygenation: a narrative review.Critical care (London, England) · 2026Review
- Drug sequestration and metabolite formation: key pharmacokinetic challenges for levosimendan use during ECMO support in cardiogenic shock.Journal of intensive care · 2026Article
- Cardiogenic shock and acute renal failure associated mortality trends in the United States: a retrospective analysis of death records from 1999 to 2023.BMC cardiovascular disorders · 2026Article
- Outcomes and prediction of mortality in patients requiring prolonged veno-arterial extracorporeal membrane oxygenation support in the PRECISE-ECLS observational study.Critical care (London, England) · 2026Observational
- Special topics: heart failure-related cardiogenic shock, valvular heart disease and end-stage renal disease. Part 4 of the International Expert Opinion Series on Acute Heart Failure Management.Heart failure reviews · 2025Review
- Pleth Variability Index or Inferior Vena Cava Collapsibility Index? Prospective Observational Study in Volume Control and Follow-Up Acute Kidney Injury.Medicina (Kaunas, Lithuania) · 2025Observational
- Renal Dysfunction Across the Spectrum of Cardiogenic Shock: Mechanisms, Clinical Implications, and Therapeutic Strategies.Current heart failure reports · 2025Review
- Rapid-onset postoperative acute kidney injury is associated with mortality in patients with postcardiotomy cardiogenic shock.Frontiers in cardiovascular medicine · 2025Article
- Acute kidney injury and cardiogenic shock severity for mortality risk stratification in patients supported with VA ECMO.ESC heart failure · 2024Article
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Authors and funding
13 authors.
Funding
Abstract
aimsTo assess the stage of acute kidney injury (AKI), as an index of organ perfusion, combined with shock severity, measured by the Society for Cardiovascular Angiography and Interventions (SCAI) shock stage classification, to stratify the risk of mortality in patients diagnosed with cardiogenic shock (CS) and supported with venoarterial extracorporeal membrane oxygenation (VA ECMO). METHODS ANS
resultsFrom January 2018 to December 2020, consecutive adult patients diagnosed with CS and received VA ECMO were retrospectively evaluated. The highest AKI stage within 48 h after ECMO initiation was assessed using the Kidney Disease: Improving Global Outcomes criteria. We included 216 patients with a mean age of 58.8 years and 31.0% were females. 88.4% of patients received ECMO for postcardiotomy, while 11.6% for medical CS. The total in-hospital mortality was 53.2%. AKI occurred in 182 (84.3%) patients receiving ECMO for CS. AKI stage 0, 1, 2, and 3 were present in 15.7%, 17.6%, 18.1%, and 48.6% of patients with in-hospital mortality of 26.5%, 26.3%, 61.5%, and 68.6%, respectively (P < 0.001). The AKI stage (P < 0.001), SCAI shock stage before ECMO (P = 0.008), and NYHA ≥ Class III on admission (P = 0.044) were independent predictors of in-hospital mortality. The area under the receiver operating characteristic curve of 0.754 (95% confidence interval: 0.690 to 0.811) for AKI stage combined with SCAI shock stage was better than those for AKI stage (0.676), SCAI shock stage (0.657), serum lactate level (0.682), SOFA score (0.644), SVAE score (0.582), and VIS score (0.530) prior to ECMO.
conclusionsIn this single-center CS population who received VA ECMO for circulatory support, predominantly postcardiotomy cases, AKI occurred in 84.3% of the patients. AKI stage, as an index of organ perfusion combined with shock severity measured by the SCAI shock classification, demonstrates a good correlation with in-hospital mortality.
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