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Journal of The Korean Society of Emergency Medicine 2026;37(1): 1-9. |
| 일개 대학병원 응급실에 내원한 환자 중 체외심폐소생술 시행 환자의 생존 예측인자 분석 |
오명훈1
, 김선표1
, 이석기2
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1조선대학교병원 응급의학과
2조선대학교병원 심장혈관흉부외과 |
| Survival predictors among patients receiving extracorporeal cardiopulmonary resuscitation in the emergency department of a single university hospital |
| Myoung hun Oh1
, Sun Pyo Kim1
, Seog Ki Lee2
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1Department of Emergency Medicine, Chosun University College of Medicine, Gwangju, Korea
2Department of Thoracic & Cardiovascular Surgery, Chosun University College of Medicine, Gwangju, Korea |
| Correspondence |
Sun Pyo Kim ,Tel: 062-220-3285, Fax: 062-224-3501, Email: ksp93133@naver.com,
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Received: November 26, 2025; Revised: December 9, 2025 Accepted: December 16, 2025. Published online: February 28, 2026. |
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| ABSTRACT |
Objective:
Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory cardiac arrest, but its prognostic determinants in emergency department (ED) settings remain unclear. This study investigated the predictors of survival and the prognostic value of lactate and bilirubin in ECPR patients treated at a single university hospital.
Methods:
Adult ECPR patients treated in a single university hospital ED from 2018 to 2023 were reviewed retrospectively. The clinical variables, laboratory markers, and procedural factors were collected from medical records. Univariate and multivariate logistic regression analyses were performed, and lactate/bilirubin were assessed by quartiles to examine the dose-response trends.
Results:
Fifty-eight patients were included, of whom 25 (43.1%) survived to discharge. Older age, higher lactate, and elevated bilirubin were associated with mortality, and all three remained independent predictors in multivariate analysis (age odds ratio [OR], 0.93; lactate OR, 0.97; bilirubin OR, 0.41). Survival declined markedly across the lactate (68.8%→0%) and bilirubin quartiles (60.0%→13.3%; P for trend <0.01). The cardiopulmonary resuscitation (CPR) to extracorporeal membrane oxygenation (ECMO) time was shorter in the survivors than the non-survivors (39.9±18.9 min vs. 51.8±23.2 min; P=0.069), whereas the door to ECMO time did not differ.
Conclusion:
Higher lactate and bilirubin concentrations, advanced age, and prolonged CPR to ECMO time were independently associated with poor outcomes after ECPR. Early ECMO initiation and prompt metabolic correction may improve survival in cardiac arrest patients receiving ECPR in the ED. |
| Key words:
Cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Lactates; Bilirubin |
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