Factors Affecting Mortality in Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Analysis

Objectives: This study aimed to evaluate the clinical, demographic, and process-related factors affecting in-hospital mortality among patients undergoing extracorporeal membrane oxygenation (ECMO).
Methods: This single-center retrospective study included data from a total of 279 patients (233 adults and 46 pediatric patients) who underwent ECMO between 01 January 2014 and 31 December 2023. Patient demographics, ECMO indications, ECMO configurations, sites and timing of ECMO initiation, duration of ECMO support, and clinical outcomes were analyzed. A p value <0.05 was considered statistically significant.
Results: The most common indication for ECMO was post-cardiotomy failure (36.5%), followed by COVID-19–related acute respiratory failure (26%). Veno-arterial ECMO was the most frequently used configuration in both adult and pediatric patients, whereas veno-venous ECMO was associated with the longest duration of support. Pediatric patients demonstrated significantly higher ECMO weaning and hospital discharge rates than adults.
Conclusion: Pediatric patients receiving ECMO showed higher rates of successful weaning and hospital discharge compared with adults. While patient age and ECMO indication were significant determinants of mortality, ECMO configuration, timing, and site of initiation were not independently associated with mortality or weaning success.

Keywords: Extracorporeal membrane oxygenation, mortality, survival