Abstract/Description/Artist Statement
Objectives:
The COVID-19 pandemic expanded and altered general ECMO utilization and provider experience; however, any impact on trauma-specific ECMO practice following this shift remains unclear. We hypothesize that trauma ECMO utilization patterns, timing of initiation, and outcomes have differed following COVID-19.
Methods:
We conducted a retrospective cohort study of trauma patients receiving ECMO (2017-2024) using the American College of Surgeons Trauma Quality Improvement Program (TQIP) Participant Use Files. The primary exposure was the COVID era (2017-2019 vs. 2021-2024). Primary outcomes included ECMO utilization, time to initiation, and in-hospital mortality; secondary outcomes included discharge disposition, major complications, and length of stay measures. Baseline characteristics were compared using χ² and Wilcoxon rank-sum tests, with adjusted analyses using multivariable logistic and linear regression.
Results
A total of 2,108 adult trauma ECMO patients were identified. Baseline characteristics and unadjusted outcomes between cohorts are outlined in Table 1. Post-COVID patients included a higher proportion of Hispanic or Latino individuals and lower weighted Elixhauser Co-morbidity Index scores. The post-COVID period was associated with higher rates of massive transfusion, VTE prophylaxis, and reported ECMO use in community teaching hospitals. As seen in Figure 1, proportional reported ECMO utilization increased over time, with a transient decline in 2021-2022. While multivariate analysis yielded significant covariates, no differences were seen in mortality, time to ECMO, CVA risk, or discharge disposition related to COVID period.
Discussion:
Despite no independent period effect on major outcomes and complications, our findings outline trauma ECMO utilization patterns and major practice characteristics that have shifted following the COVID-19 pandemic.
Faculty Advisor/Mentor
Samantha Olafson
Faculty Advisor/Mentor Email
solafson@odu.edu
Faculty Advisor/Mentor Department
Eastern Virginia Medical School Department of Surgery
College/School Affiliation
Eastern Virginia School of Medicine
Student Level Group
Medical
Presentation Type
Poster
Included in
Extracorporeal Membrane Oxygenation in Trauma Before and After COVID-19: Associations of Utilization, Timing, and Outcomes
Objectives:
The COVID-19 pandemic expanded and altered general ECMO utilization and provider experience; however, any impact on trauma-specific ECMO practice following this shift remains unclear. We hypothesize that trauma ECMO utilization patterns, timing of initiation, and outcomes have differed following COVID-19.
Methods:
We conducted a retrospective cohort study of trauma patients receiving ECMO (2017-2024) using the American College of Surgeons Trauma Quality Improvement Program (TQIP) Participant Use Files. The primary exposure was the COVID era (2017-2019 vs. 2021-2024). Primary outcomes included ECMO utilization, time to initiation, and in-hospital mortality; secondary outcomes included discharge disposition, major complications, and length of stay measures. Baseline characteristics were compared using χ² and Wilcoxon rank-sum tests, with adjusted analyses using multivariable logistic and linear regression.
Results
A total of 2,108 adult trauma ECMO patients were identified. Baseline characteristics and unadjusted outcomes between cohorts are outlined in Table 1. Post-COVID patients included a higher proportion of Hispanic or Latino individuals and lower weighted Elixhauser Co-morbidity Index scores. The post-COVID period was associated with higher rates of massive transfusion, VTE prophylaxis, and reported ECMO use in community teaching hospitals. As seen in Figure 1, proportional reported ECMO utilization increased over time, with a transient decline in 2021-2022. While multivariate analysis yielded significant covariates, no differences were seen in mortality, time to ECMO, CVA risk, or discharge disposition related to COVID period.
Discussion:
Despite no independent period effect on major outcomes and complications, our findings outline trauma ECMO utilization patterns and major practice characteristics that have shifted following the COVID-19 pandemic.