P1172 - Utilization and Outcomes of Extracorporeal Membrane Oxygenation in Patients With Cirrhosis

Spencer Goble, MD¹, Yasmin O. Ali, MBBS², Thomas M. Leventhal, MD^1
1University of Minnesota, Minneapolis, MN; ²Hennepin Healthcare, Minneapolis, MN

Introduction: Extracorporeal membrane oxygenation (ECMO) is an increasingly common method of supporting critically ill patients, yet utilization and outcomes of ECMO in patients with cirrhosis has been minimally investigated.

Methods: This is a retrospective study using the National Inpatient Sample to assess hospitalizations for patients with cirrhosis managed with either venoarterial or venovenous ECMO from 2016-2021. Hospitalizations were organized based off their primary admission diagnosis, defined as the diagnosis chiefly responsible for the admission, into one of the following categories: liver disease, cardiovascular failure, sepsis, respiratory failure, and other. In-hospital mortality was compared to patients without cirrhosis and assessed in each group. Liver transplant incidence and outcomes was assessed in those admitted for complications of liver disease.

Results: A total of 1,135 hospitalizations were included. The mean age of the cohort was 55.7 years, 30.4% of patients were female and the majority (68.8%) were white. Liver disease was the most common reason for admission (n=475, 41.9%) followed by cardiovascular failure (n=275, 24.2%), sepsis (n=170, 15.0%), respiratory failure (n=145, 12.8%) and other causes (n=70, 6.2%). Overall mortality did not significantly differ from patients without cirrhosis (n=67,495) (46.3% vs 44.7%, OR=1.07, 95% CI: 0.78-1.45, p=0.687). In patients with cirrhosis, mortality was highest in those admitted for cardiovascular failure (67.3%), followed by sepsis (58.8%), respiratory failure (58.6%), other causes (42.9%) and liver disease (26.3%). Liver transplant was performed in 95.8% (n=455) of patients admitted for complications of liver failure and mortality in this cohort was 24.2%.

Discussion: In the largest to date assessment of ECMO in patients with cirrhosis, overall mortality was comparable to patients without cirrhosis and outcomes appeared to be best when ECMO was used in the peritransplant setting.


Disclosures:


Spencer Goble, MD¹, Yasmin O. Ali, MBBS², Thomas M. Leventhal, MD¹. P1172 - Utilization and Outcomes of Extracorporeal Membrane Oxygenation in Patients With Cirrhosis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.