scholarly journals Comparison of Mortality Risk Models in Patients with Postcardiac Arrest Cardiogenic Shock and Percutaneous Mechanical Circulatory Support

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Georgios Chatzis ◽  
Birgit Markus ◽  
Styliani Syntila ◽  
Christian Waechter ◽  
Ulrich Luesebrink ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Apache Ii ◽  
Circulatory Support ◽  
Saps Ii ◽  
Prognostic Accuracy ◽  
Va Ecmo

Background. Although scoring systems are widely used to predict outcomes in postcardiac arrest cardiogenic shock (CS) after out-of-hospital cardiac arrest (OHCA) complicating acute myocardial infarction (AMI), data concerning the accuracy of these scores to predict mortality of patients treated with Impella in this setting are lacking. Thus, we aimed to evaluate as well as to compare the prognostic accuracy of acute physiology and chronic health II (APACHE II), simplified acute physiology score II (SAPS II), sepsis-related organ failure assessment (SOFA), the intra-aortic balloon pump (IABP), CardShock, the prediction of cardiogenic shock outcome for AMI patients salvaged by VA-ECMO (ENCOURAGE), and the survival after venoarterial extracorporeal membrane oxygenation (SAVE) score in patients with OHCA refractory CS due to an AMI treated with Impella 2.5 or CP. Methods. Retrospective study of 65 consecutive Impella 2.5 and 32 CP patients treated in our cardiac arrest center from September 2015 until June 2020. Results. Overall survival to discharge was 44.3%. The expected mortality according to scores was SOFA 70%, SAPS II 90%, IABP shock 55%, CardShock 80%, APACHE II 85%, ENCOURAGE 50%, and SAVE score 70% in the 2.5 group; SOFA 70%, SAPS II 85%, IABP shock 55%, CardShock 80%, APACHE II 85%, ENCOURAGE 75%, and SAVE score 70% in the CP group. The ENCOURAGE score was the most effective predictive model of mortality outcome presenting a moderate area under the curve (AUC) of 0.79, followed by the CardShock, APACHE II, IABP, and SAPS score. These derived an AUC between 0.71 and 0.78. The SOFA and the SAVE scores failed to predict the outcome in this particular setting of refractory CS after OHCA due to an AMI. Conclusion. The available intensive care and newly developed CS scores offered only a moderate prognostic accuracy for outcomes in OHCA patients with refractory CS due to an AMI treated with Impella. A new score is needed in order to guide the therapy in these patients.

scholarly journals The Pros and Cons of the Prediction Game: The Never-ending Debate of Mortality in the Intensive Care Unit

2019 ◽  
Vol 16 (18) ◽  
pp. 3394 ◽  
Author(s):  
Piotr A. Fuchs ◽  
Iwona J. Czech ◽  
Łukasz J. Krzych
Keyword(s):  
Intensive Care ◽  
Scoring Systems ◽  
Roc Curves ◽  
Simplified Acute Physiology Score ◽  
Apache Ii ◽  
Icu Mortality ◽  
Saps Ii ◽  
Icu Discharge ◽  
Pros And Cons ◽  
Long Term Prognosis

Background: The Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II, and Sequential Organ Failure Assessment (SOFA) scales are scoring systems used in intensive care units (ICUs) worldwide. We aimed to investigate their usefulness in predicting short- and long-term prognosis in the local ICU. Methods: This single-center observational study covered 905 patients admitted from 1 January 2015 to 31 December 2017 to a tertiary mixed ICU. SAPS II, APACHE II, and SOFA scores were calculated based on the worst values from the first 24 h post-admission. Patients were divided into surgical (SP) and nonsurgical (NSP) subjects. Unadjusted ICU and post-ICU discharge mortality rates were considered the outcomes. Results: Baseline SAPS II, APACHE II, and SOFA scores were 41.1 ± 20.34, 14.07 ± 8.73, and 6.33 ± 4.12 points, respectively. All scores were significantly lower among SP compared to NSP (p < 0.05). ICU mortality reached 35.4% and was significantly lower for SP (25.3%) than NSP (57.9%) (p < 0.001). The areas under the receiver-operating characteristic (ROC) curves were 0.826, 0.836, and 0.788 for SAPS II, APACHE II, and SOFA scales, respectively, for predicting ICU prognosis, and 0.708, 0.709, and 0.661 for SAPS II, APACHE II, and SOFA, respectively, for post-ICU prognosis. Conclusions: Although APACHE II and SAPS II are good predictors of ICU mortality, they failed to predict survival after discharge. Surgical patients had a better prognosis than medical ICU patients.

scholarly journals The Simplified Acute Physiology Score III Is Superior to the Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II in Predicting Surgical and ICU Mortality in the “Oldest Old”

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Aftab Haq ◽  
Sachin Patil ◽  
Alexis Lanteri Parcells ◽  
Ronald S. Chamberlain
Keyword(s):  
Roc Curve ◽  
Oldest Old ◽  
Binary Logistic Regression ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Acute Physiology Score ◽  
Apache Ii ◽  
Binary Logistic Regression Analysis ◽  
Saps Ii ◽  
The Usa

Elderly patients in the USA account for 26–50% of all intensive care unit (ICU) admissions. The applicability of validated ICU scoring systems to predict outcomes in the “Oldest Old” is poorly documented. We evaluated the utility of three commonly used ICU scoring systems (SAPS II, SAPS III, and APACHE II) to predict clinical outcomes in patients > 90 years. 1,189 surgical procedures performed upon 951 patients > 90 years (between 2000 and 2010) were analyzed. SAPS II, SAPS III, and Acute APACHE II were calculated for all patients admitted to the SICU. Differences between survivors and nonsurvivors were analyzed using the Student’st-test and binary logistic regression analysis. A receiver operating characteristic (ROC) curve was constructed for each scoring system studied. The area under the ROC curve (aROC) for the SAPS III was 0.81 at a cut-off value of 57, whereas the aROC for SAPS II was 0.75 at a cut-off score of 44 and the aROC for APACHE II was 0.74 at a cut-off score of 13. The SAPS III ROC curve for prediction of hospital mortality exhibited the greatest sensitivity (84%) and specificity (66%) with a score of 57 for the “Oldest Old” population.

Effectiveness of the sequential organ failure assessment, acute physiology and chronic health evaluation II, and simplified acute physiology score II prognostic scoring systems in paraquat-poisoned patients in the intensive care unit

2016 ◽  
Vol 36 (5) ◽  
pp. 431-437 ◽  
Author(s):  
Jun Ho Lee ◽  
Seong Youn Hwang ◽  
Hye Ran Kim ◽  
Yang Won Kim ◽  
Mun Ju Kang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Sofa Score ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Health Evaluation ◽  
Saps Ii ◽  
Failure Assessment ◽  
Score Apache

Objective: This study was conducted to assess the ability of the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) II scoring systems, as well as the simplified acute physiology score (SAPS) II method to predict group mortality in intensive care unit (ICU) patients who were poisoned with paraquat. This will assist physicians with risk stratification. Material and methods: The medical records of 244 paraquat-poisoned patients admitted to the ICU from January 2010 to April 2015 were examined retrospectively. The SOFA, APACHE II, and SAPS II scores were calculated based on initial laboratory data in the emergency department and during the first 24 h of ICU admission. The probability of death was calculated for each patient based on the SOFA score, APACHE II score, and SAPS II. The ability of the SOFA score, APACHE II score, and SAPS II method to predict group mortality was assessed using a receiver operating characteristic (ROC) curve and calibration analyses. Results: A total of 219 patients (mean age, 63 years) were enrolled. Sensitivities, specificities, and accuracies were 58.5%, 86.1%, and 64.0% for the SOFA, respectively; 75.1%, 86.1%, and 77.6% for the APACHE II scoring systems, respectively; and 76.1%, 79.1%, and 76.7% for the SAPS II, respectively. The areas under the curve in the ROC curve analysis for the SOFA score, APACHE II scoring system, and SAPS II were 0.716, 0.850, and 0.835, respectively. Conclusion: The SOFA, APACHE II, and SAPS II had different capabilities to discriminate and estimate early in-hospital mortality of paraquat-poisoned patients. Our results show that although the SOFA and SAPS II are easier and more quickly calculated than APACHE II, the APACHE II is superior for predicting mortality. We recommend use of the APACHE II for outcome predictions and risk stratification in paraquat-poisoned patients in the ICU.

scholarly journals Chronic heart failure in intensive care unit: can we accurately predict the risk?

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Maltes ◽  
S Maltes ◽  
B.M.L Rocha ◽  
G.J.L Cunha ◽  
P Lopes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Kidney Injury ◽  
Scoring Systems ◽  
Roc Curves ◽  
Simplified Acute Physiology Score ◽  
Apache Ii ◽  
Risk Scores ◽  
Risk Of Death ◽  
Saps Ii

Abstract Background Severity of disease scoring systems, namely the Simplified Acute Physiology Score (SAPS) and Acute Physiology and Chronic Health Evaluation (APACHE), are widely used to predict mortality in Intensive Care Units (ICU). Yet, neither score includes chronic HF in their model. We aimed to evaluate whether these scores perform well in risk prediction of death of patients previously diagnosed with heart failure (HF). Methodology This is a single-center retrospective cohort of patients admitted to an ICU in 2019. Those whose admission lasted &lt;24 hours were excluded from analysis. The SAPS II and APACHE II scores were calculated using data from the first 24 hours of ICU admission, imputing the worst variable obtained within this timeframe. HF was defined according to the ESC recommendations. In order to assess the performance of the scores, Receiver Operating Characteristic (ROC) Curves were used to predict the risk of death in ICU in HF compared to the non-HF population. Results A total of 267 patients were hospitalized in ICU for a period over 24 hours in 2019 (mean age 67±16 years; 58.8% males; 21.7% with chronic HF; 33.7% admitted for sepsis). Compared to patients without HF, those with chronic HF were older (74±13 vs. 65±16 years; p&lt;0.001) and had higher risk scores (mean SAPS II: 43.2±21.7 vs. 56.5±20.7; p&lt;0.001; mean APACHE II: 19.8±10.0 vs. 25.1±10.0; p&lt;0.001). Moreover, these patients were at higher risk of meaningful events during hospitalization (e.g. acute kidney injury: 38.0 vs. 66.1%; p&lt;0.001; shock at any time: 52.4 vs. 67.8%; p=0.036). Furthermore, patients with HF had a trend towards higher mortality rates in ICU (17.3 vs. 28.8%; p=0.051) and a significantly higher death in overall hospitalization (30.8 vs. 45.8%; p=0.032). ROC curves performed well in predicting the risk of ICU death regardless of HF (SAPS II – AUC 0.78 vs. 0.81; p=0.36; APACHE II – AUC 0.75 vs. 0.78; p=0.37). Conclusion Approximately 1 in every 4 patients admitted to the ICU had chronic HF. Traditional risk scoring systems (SAPS II and APACHE II) performed well regardless of HF. While these results are reassuring as far as risk stratification accuracy is concerned, HF patients remained at a higher risk for worse outcomes. Therefore, prognostic tools with a therapeutic clinical applicability are urgently needed to improve the outcome of this population. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Predicting mortality in adult patients with sepsis in the emergency department by using combinations of biomarkers and clinical scoring systems: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirby Tong-Minh ◽  
Iris Welten ◽  
Henrik Endeman ◽  
Tjebbe Hagenaars ◽  
Christian Ramakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Scoring System ◽  
Early Stage ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Prognostic Accuracy ◽  
Clinical Scoring ◽  
Qsofa Score

Abstract Background Sepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED. Methods We performed a systematic search using MEDLINE, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the prognostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. We did not define biomarker cut-off values in advance. Results We included 18 articles in which a total of 35 combinations of biomarkers and clinical scoring systems were studied, of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. Conclusion The studies we found in this systematic review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis. Future studies should focus on clinical scoring systems which require a limited amount of clinical parameters, such as the qSOFA score in combination with a biomarker that is already routinely available in the ED.

scholarly journals Predicting Mortality in Adult Patients With Sepsis in the Emergency Department by Using Combinations of Biomarkers and Clinical Scoring Systems: A Systematic Review.

2021 ◽  
Author(s):  
Kirby Tong-Minh ◽  
Iris Welten ◽  
Henrik Endeman ◽  
Tjebbe Hagenaars ◽  
Christian Ramakers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Scoring System ◽  
Early Stage ◽  
Area Under The Curve ◽  
Scoring Systems ◽  
Simplified Acute Physiology Score ◽  
Prognostic Accuracy ◽  
Multiple Biomarkers ◽  
Clinical Scoring

Abstract IntroductionSepsis can be detected in an early stage in the emergency department (ED) by biomarkers and clinical scoring systems. A combination of multiple biomarkers or biomarker with clinical scoring system might result in a higher predictive value on mortality. The goal of this systematic review is to evaluate the available literature on combinations of biomarkers and clinical scoring systems on 1-month mortality in patients with sepsis in the ED.MethodsWe performed a systematic search using MEDLINE, EMBASE and Google Scholar. Articles were included if they evaluated at least one biomarker combined with another biomarker or clinical scoring system and reported the prognostic accuracy on 28 or 30 day mortality by area under the curve (AUC) in patients with sepsis. ResultsWe included 18 articles in which a total of 35 combinations of biomarkers and clinical scoring systems were studied, of which 33 unique combinations. In total, seven different clinical scoring systems and 21 different biomarkers were investigated. The combination of procalcitonin (PCT), lactate, interleukin-6 (IL-6) and Simplified Acute Physiology Score-2 (SAPS-2) resulted in the highest AUC on 1-month mortality. ConclusionThe combination of PCT, IL-6, lactate and the SAPS-2 score had the highest AUC on 1-month mortality in patients with sepsis in the ED. The studies we found in this review were too heterogeneous to conclude that a certain combination it should be used in the ED to predict 1-month mortality in patients with sepsis.

scholarly journals COVID-19 era: time for temporary mechanical circulatory support?

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Alonso Fernandez De Gatta ◽  
A Diego Nieto ◽  
S Merchan Gomez ◽  
M Gonzalez Cebrian ◽  
I Toranzo Nieto ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Public Institution ◽  
Left Ventricular Ejection ◽  
Circulatory Support ◽  
Short Term ◽  
Ventricular Ejection Fraction ◽  
Va Ecmo

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Instituto de Salud Carlos III in Spain (Co-funded by European Social Fund "Investing in your future"). INTRODUCTION The Coronavirus disease 19 (COVID-19) pandemic has impacted clinical practice with important changes in the most affected areas, resulting in increased mortality from heart disease (myocardial infarction). The feasibility of continuing a temporary mechanical circulatory support (MCS) program is unknown. PURPOSE Our objective was to analyze the survival of patients requiring short-term MCS with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP® during the COVID-19 pandemic. METHODS Retrospective study including all VA-ECMO and Impella CP® implants in a referral hospital since March 2020 compared to previous implants results. RESULTS Out of 167 short-term MCS implanted from 2013, 25 (15%) were conducted during the time of COVID-19 pandemic: 19 VA-ECMO and 6 Impella CP® (Table). Compared to preCOVID-19 implants, patients requiring MCS in the COVID era presented more frequently right ventricular dysfunction (p = 0.005) and showed a trend towards older age (p = 0.069) and lower left ventricular ejection fraction (p = 0.063), without other significant differences regarding the baseline situation and implant technique (Table). Encephalopathy was more frequent in the COVID-19 era, with no differences in other complications (Table). Survival at discharge was 43.7% in the pre-COVID era vs 36% during COVID-19 pandemic, without finding statistically significant differences (p = 0.313). CONCLUSION Survival after temporary MCS did not get worse significantly during the COVID-19 pandemic. The possibility of short-term MCS should be maintained for cardiogenic shock and other cases of hemodynamic instability. Comparison MCS before and during COVIDTime of implantP valueTime of implantP valuePre-COVID-192013-Feb 2020 (n = 142)COVID-19 timeMarch 2020-Nov 2020 (n = 25)Pre-COVID-192013-Feb 2020 (n = 142)COVID-19 timeMarch 2020-Nov 2020 (n = 25)Age (years) (mean+ SD)Male (n, %)62 ± 10 108 (76%)66 ± 10 15 (60%)0.069 0.079Support type VA-ECMO (n = 137) Impella CP® (n = 30) Percutaneous implant 118 (83.1%)24 (16.9%) 100 (70.4% 19 (76%) 6 (24%) 20 (80%)0.566 0.536Indication (n,%) Cardiogenic shock Refractory cardiac arrest Electrical storm0.63763 (44.4%)16 (11.3%)9 (6.3%)12 (48%) 4 (16%)2 (8%)Drugs at the implant Noradrenaline Dobutamine Adrenaline 115 (81%)114 (80.3%)51 (35.9%) 21 (84%) 21 (84%) 5 (20%) 0.370 0.312 0.108High-risk PCI Postcardiotomy shock Others17 (12%)36 (25.4%)1 (0.7%)3 (12%)4 (16%) 0 (0%)Time MCS (days)4.8 ± 53.9 ± 40.284 7.23 ± 0.16.8 ± 5 0.2920.495Complications (n,%) Vascular (bleeding, ischemia) Bleeding (minor or major) Critical care infections 35 (24.6%)59 (41.5%)67 (47.2%) 7 (28%) 9 (36%) 9 (36%) 0.096 0.117 0.096pH (mean + SD)lactate (mmol/L) (mean + SD)7.13 ± 16.03 ± 5LVEF (%) (mean + SD)Right ventricle dysfunction (n,%)28.7 ± 16 68 (47.9%)21.9 ± 15 20 (80%)0.063 0.005Ischemic/hemorragic stroke Renal replacement therapy Tracheostomy Encephalopathy9 (6.3%) 36 (25.4%) 23 (16.2%)14 (9.8%)2 (8%) 4 (16%) 5 (20%) 6 (24%)0.220 0.136 0.547 0.023Preimplant cardiac arrest (n,%)Cardiac arrest duration (min) (n,%)68 (47.9%) 28.7 ± 2312 (48%) 29.8 ± 230.364 0.880Survival at discharge (n,%)62 (43.7%)9 (36%)0.313

Veno-Arterial Extracorporeal Membrane Oxygenation in the Adult: A Bridge to the State of the Art

2020 ◽  
Vol 16 ◽  
Author(s):  
Marco Gennari ◽  
Camilla L’Acqua ◽  
Mara Rubino ◽  
Marco Agrifoglio ◽  
Luca Salvi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiogenic Shock ◽  
Circulatory Arrest ◽  
Adult Population ◽  
Membrane Oxygenation ◽  
Refractory Cardiogenic Shock ◽  
Vital Functions ◽  
Negative Condition ◽  
Hospital Institution ◽  
Va Ecmo

Abstract:: Despite the technological improvements of the last 40 years conditions such as refractory cardiogenic shock and cardiac arrest still present a very high mortality rate in the real-world clinical practice. In this light we have performed a review of the techniques, indications, contraindications and results of the so-called Veno-Arterial Extracorporeal Circulatory Membrane Oxygenation (VA-ECMO) in the adult population to evaluate the current results of this temporary cardio-pulmonary support as salvage and/or bridge therapy in patient suffering from refractory cardiogenic shock or cardio-circulatory arrest. The results are encouraging, especially in the setting of refractory cardiogenic shock and in-hospital cardiac arrest. Among a selected population the prompt institution of a VA-ECMO may radically change the prognosis by sustaining vital functions while looking for the leading cause or waiting for the reversal of the temporary cardio-respiratory negative condition. The future directions aim to standardized and shared protocols, miniaturization of the machines and possibly the institution of specialized “ECMO teams” for in and out-of-hospital institution of the tool.

scholarly journals Quality of Life Following Urgent LVAD Implantation for ECMO Therapy in Cardiogenic Shock: A Long-Term Follow-Up

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 747
Author(s):  
Rafal Berger ◽  
Hasan Hamdoun ◽  
Rodrigo Sandoval Boburg ◽  
Medhat Radwan ◽  
Metesh Acharya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiogenic Shock ◽  
Left Ventricular ◽  
Ecmo Support ◽  
Circulatory Support ◽  
Significant Difference ◽  
Va Ecmo ◽  
Ecmo Therapy

Background and Objectives: Over the past decade, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has developed into a mainstream treatment for refractory cardiogenic shock (CS) to maximal conservative management. Successful weaning of VA-ECMO may not be possible, and bridging with further mechanical circulatory support (MCS), such as urgent implantation of a left ventricular assist device (LVAD), may represent the only means to sustain the patient haemodynamically. In the recovery phase, many survivors are not suitably prepared physically or psychologically for the novel issues encountered during daily life with an LVAD. Materials and Methods: A retrospective analysis of our institutional database between 2012 and 2019 was performed to identify patients treated with VA-ECMO for CS who underwent urgent LVAD implantation whilst on MCS. Post-cardiotomy cases were excluded. QoL was assessed prospectively during a routine follow-up visit using the EuroQol-5 dimensions-5 level (EQ-5D-5L) and the Patient Health Questionnaire (PHQ-9) surveys. Results: Among 126 in-hospital survivors of VA-ECMO therapy due to cardiogenic shock without prior cardiac surgery, 31 (24.6%) urgent LVAD recipients were identified. In 11 (36.7%) cases, cardiopulmonary resuscitation (CPR) was performed (median 10, range 1–60 min) before initiation of VA-ECMO, and in 5 (16.7%) cases, MCS was established under CPR. Mean age at LVAD implantation was 51.7 (+/−14) years and surgery was performed after a mean 12.1 (+/−8) days of VA-ECMO support. During follow-up of 46.9 (+/−25.5) months, there were 10 deaths after 20.4 (+/−12.1) months of LVAD support. Analysis of QoL questionnaires returned a mean EQ-5D-5L score of 66% (+/−21) of societal valuation for Germany and a mean PHQ-9 score of 5.7 (+/−5) corresponding to mild depression severity. When compared with 49 elective LVAD recipients without prior VA-ECMO therapy, there was no significant difference in QoL results. Conclusions: Patients requiring urgent LVAD implantation under VA-ECMO support due to CS are associated with comparable quality of life without a significant difference from elective LVAD recipients. Close follow-up is required to oversee patient rehabilitation after successful initial treatment.

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