Becher et al reported the ECMO-ACCEPTS score for predicting in-hospital mortality for a patient receiving venoarterial extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support. The score can help to identify a patient who may have a worse prognosis. The authors are from multiple institutions in Germany and Switzerland.
ECMO-ACCEPTS is an acronymn created from letters in the parameters.
Patient selection: venoarterial ECMO for cardiopulmonary support
Outcome: 30-day in-hospital mortality
Parameters:
(1) age in years
(2) acuity of admission
(3) prior cardiopulmonary resuscitation (CPR)
(4) atrial fibrillation
(5) coronary artery disease
(6) congestive heart failure
(7) pulmonary hypertension
(8) arterial hypertension
(9) heart transplantation
(10) acute coronary syndrome
|
Parameter
|
Finding
|
Points
|
|
age
|
<= 65 years
|
0
|
|
|
> 65 years
|
3
|
|
acuity of admission
|
urgent
|
1
|
|
|
non-urgent
|
0
|
|
prior CPR
|
no
|
0
|
|
|
yes
|
4
|
|
atrial fibrillation
|
no
|
0
|
|
|
yes
|
4
|
|
coronary artery disease
|
no
|
0
|
|
|
yes
|
2
|
|
congestive heart failure
|
no
|
0
|
|
|
yes
|
2
|
|
pulmonary hypertension
|
no
|
0
|
|
|
yes
|
3
|
|
arterial hypertension
|
no
|
0
|
|
|
yes
|
2
|
|
heart transplantation
|
no
|
0
|
|
|
yes
|
14
|
|
acute coronary syndrome
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 37
|
Total Score
|
Predicted Mortality
|
|
<= 18
|
36%
|
|
19 or 20
|
44%
|
|
21 or 22
|
50%
|
|
23 or 24
|
56%
|
|
25 or 26
|
62%
|
|
27 or 28
|
68%
|
|
29 or 30
|
74%
|
|
31 or 32
|
79%
|
|
>=33
|
85%
|
Performance:
• The area under the ROC curve is 0.64.
