Higher rate of new mental health diagnoses among ECMO survivors

According to a recent study, critically ill patients who received extracorporeal membrane oxygenation (ECMO) while hospitalized were at increased risk for new mental health diagnoses.

An advanced form of resuscitation, ECMO provides temporary respiratory and/or cardiac support to patients and is often considered when conventional treatment fails. Researchers examined the association between patients who survive after ECMO use and mental health diagnoses after discharge.

Researchers conducted a population-based retrospective cohort study from April 2010 to March 2020 with adult patients (n=4462) who were admitted to the intensive care unit (ICU) and ultimately discharged from the hospital. Of the total, 642 patients received ECMO (mean age, 50.7 years) and had a median follow-up of 730 days. A total of 3820 patients did not receive ECMO (mean age, 51 years) and had a median follow-up of 1390 days.

For the study, the researchers looked for a new post-discharge mental diagnosis that could be: a composite of mood disorders, anxiety disorders, post-traumatic stress disorder; schizophrenia, other psychotic disorders; other mental health disorders; and social issues. Of the total number of patients who survived ECMO, 37% (n=236) received a new mental health diagnosis. Comparatively, 40.9% (n=1565) of patients who survived ECMO were diagnosed with a new mental health problem.

Overall, the researchers found a 24% higher rate of new mental health diagnoses in patients who received ECMO compared to intensive care patients who did not receive ECMO. There was no significant association between substance after discharge in people who received ECMO.

“The results of this current study show that diagnoses of new mental health conditions were common among survivors after ECMO,” the researchers concluded. “The most frequent diagnoses were related to depression, anxiety and traumatic disorders, which was not surprising given the invasive nature of intensive care. Such diagnoses are the most common among all adult survivors of critical illness…this work provides important insights for clinicians regarding psychological support for survivors after discharge.

—Jessica Ganga

Reference:

Fernando SM, Scott M, Talarico R, et al. Association of extracorporeal membrane oxygenation with new mental health diagnoses in adult survivors of critical illness. JAMA. Published online October 26, 2022. doi:10.1001/jama.2022.17714

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