Predictive Score for Survival After Percutaneous Cardiopulmonary Support in Cardiovascular Disease Patients

– Evaluation of Pre-Procedural Information –

Abstract

Background: The predictive factors for survival after percutaneous cardiopulmonary support (PCPS) are unknown. Methods and Results: Data for 105 patients with cardiovascular disease requiring PCPS were analyzed. The patients were divided into a survivor (n=21) or a non-survivor group (n=84). The age was significantly lower, and there were more patients with fulminant myocarditis and PCPS attempted before cardiac arrest (CA) in the survivor group. Additionally, there were fewer cases of out-of-hospital CA, and the mean time from CA to PCPS was shorter in the survivor group. On multivariate logistic regression it was found that the age and the time from CA to PCPS were independently associated with survival. A predictive scoring system was constructed that included the following: (1) age <50 years; (2) diagnosis of fulminant myocarditis; (3) no out-of-hospital CA; (4) PCPS attempted before CA; and (5) time from CA to PCPS <45min. The predictive score was significantly higher in the survivor than in the non-survivor group (2.33±1.32 vs. 1.06±1.02). The sensitivity and specificity for survival were 85.7% and 66.7% when the score was ≥2. Kaplan-Meier survival analysis showed that any-cause death was significantly higher in patients with PCPS survival score ≤1 than in those with a score ≥2. Conclusions: PCPS survival score is suitable for clinically predicting survival in patients with cardiovascular disease undergoing PCPS.  (Circ J 2013; 77: 2064–2072)