The socio-economic characteristics of arrest patients with VA ECMO for 8 years: A national Health Insurance database study

초록

Introduction: We intended to analyze the influencing factors basic socio-economic characteristics, comorbidities, on short-term and long-term outcome in the arrest patients with and without VA-ECMO using National health Insurance Service (NHIS) database. Methods: The patients (> 20 yrs) with claim with cardiac arrest events from 2007 to 2015 were included. Demographics, insurance type, level and volume of hospital, urbanization level, therapies, medical expenses were analyzed using NHIS database (ICD-10) in VA-ECMO group and non-VA-ECMO group. Outcome endpoints were short-term (30 days), mid-term (6 months), and long-term (1 year) mortality. SAS ver 9.4 were used for proc-genmod logistics. Results: 3,860 of 306,337 patients were included to VA-ECMO group, that showed younger patients, lower rate of medical aid, higher level of hospital, lower charlson comorbidity index, compared with non-VA-ECMO group. 72% of VA-ECMO group were admitted through emergency room. The short-term, mid-term and long-term mortality rate in VA-ECMO group were 74.7%, 81.0% and 81.7%, compared with 84.8%, 91.1% and 91.9% in non-VA-ECMO group. Short-term (< 30 days) and long-term (30 days~1 year) medical expense were $24,744and$34,124 in VA-ECMO group, compared to $6,951and$27,616 in non-VA-ECMO group. After adjusting characteristics, VA-ECMO group did not show any decreasing mortality rate. Conclusion: VA- ECMO group showed better outcome for long-term period under limited conditions, considering age, gender, health insurance, hospital level, and urbanization. Medical expense in VA-ECMO was greater than in non-VA ECMO group, especially during short-term.