The European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery: third report

Theo M.M.H. De By*, Felix Schoenrath, Kevin M. Veen, Paul Mohacsi, Julia Stein, Khalid M.M. Alkhamees, Kyriakos Anastasiadis, Alexander Berhnardt, Friedhelm Beyersdorf, Kadir Caliskan, David Reineke, Kevin Damman, Arnt Fiane, Angeliki Gkouziouta, Can Gollmann-Tepeköylü, Finn Gustafsson, Michal Hulman, Attilio Iacovoni, Antonio Loforte, Bela MerkelyFrancesco Musumeci, Petr Němec, Ivan Netuka, Mustafa Özbaran, Evgenij Potapov, Yuri Pya, Gregorio Rábago, Faiz Ramjankhan, Hermann Reichenspurner, Diyar Saeed, Elena Sandoval, Bernard Stockman, Marc Vanderheyden, Laurens Tops, Thorsten Wahlers, Michael Zembala, Daniel Zimpfer, Thierry Carrel, Jan Gummert, Bart Meyns

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

OBJECTIVES: In the third report of the European Registry for Patients with Mechanical Circulatory Support of the European Association for Cardio-Thoracic Surgery, outcomes of patients receiving mechanical circulatory support are reviewed in relation to implant era. METHODS: Procedures in adult patients (January 2011-June 2020) were included. Patients from centres with <60% follow-ups completed were excluded. Outcomes were stratified into 3 eras (2011-2013, 2014-2017 and 2018-2020). Adverse event rates (AERs) were calculated and stratified into early phase (<3 months) and late phase (>3 months). Risk factors for death were explored using univariable Cox regression with a stepwise time-varying hazard ratio (<3 vs >3 months). RESULTS: In total, 4834 procedures in 4486 individual patients (72 hospitals) were included, with a median follow-up of 1.1 (interquartile range: 0.3-2.6) years. The annual number of implants (range: 346-600) did not significantly change (P = 0.41). Both Interagency Registry for Mechanically Assisted Circulatory Support class (classes 4-7: 23, 25 and 33%; P < 0.001) and in-hospital deaths (18.5, 17.2 and 11.2; P < 0.001) decreased significantly between eras. Overall, mortality, transplants and the probability of weaning were 55, 25 and 2% at 5 years after the implant, respectively. Major infections were mainly noted early after the implant occurred (AER<3 months: 1.44 vs AER>3 months: 0.45). Bilirubin and creatinine levels were significant risk factors in the early phase but not in the late phase after the implant. CONCLUSIONS: In its 10 years of existence, EUROMACS has become a point of reference enabling benchmarking and outcome monitoring. Patient characteristics and outcomes changed between implant eras. In addition, both occurrence of outcomes and risk factor weights are time dependent.

Original languageEnglish
Article numberezac032
JournalEuropean Journal of Cardio-thoracic Surgery
Volume62
Issue number1
Early online date12 Feb 2022
DOIs
Publication statusPublished - Jul 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

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