ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2025
Which Score Works Better? Comparing Respiratory Extra-Corporeal Membrane Oxygenation Survival Prediction and Acute Physiology and Chronic Health Evaluation II in Predicting Mortality for Veno-venous Extracorporeal Membrane Oxygenation Patients.
Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and aims: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a life-saving treatment for patients with severe respiratory failure. However, predicting the survival chances of these patients remains difficult. Two commonly used scoring systems, the respiratory ECMO survival prediction (RESP) and Acute Physiology and Chronic Health Evaluation II (APACHE II) score, help in estimating the risk of mortality. This study aimed to compare how well these two scoring systems predict mortality in VV-ECMO patients. Patients and methods: This was a retrospective study involving patients who received VV-ECMO from 2015 to 2022. We looked at factors like patient age, existing health conditions, the duration of extracorporeal membrane oxygenation (ECMO) treatment, and whether they survived or not. We also compared the actual mortality rate with the predictions made by the RESP and APACHE II scores, using the area under the curve (AUC) to evaluate how accurate each system was. Results: Out of all the patients, the actual mortality rate was 41.4%. The RESP score predicted a mortality rate of 51.1%, while APACHE II predicted 48.1%. Acute Physiology and Chronic Health Evaluation II (APACHE II) proved to be a better predictor (AUC = 0.722) compared to RESP (AUC = 0.649). Sepsis and difficulty in weaning off ECMO were strongly associated with higher mortality rates, while factors like age, comorbidities, and complications like bleeding or stroke didn't seem to have much of an impact. Conclusion: Our study found that APACHE II is a more reliable tool than RESP when it comes to predicting mortality in VV-ECMO patients. It can help doctors make more informed decisions about patient care and predict mortality. How to cite this article: Prasad J, Maqbool K, Chauhan M, Dewan S. Which Score Works Better? Comparing Respiratory Extra-Corporeal Membrane Oxygenation Survival Prediction and Acute Physiology and Chronic Health Evaluation II in Predicting Mortality for Veno-venous Extracorporeal Membrane Oxygenation Patients. Indian J Crit Care Med 2025;29(11):930-935.
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