Higher Rate of New Mental Health Diagnoses Among ECMO Survivors

Patients who were critically ill that received extracorporeal membrane oxygenation (ECMO) during hospitalization had an increased risk of new mental health diagnoses, according to a recent study.

An advanced form of life support, ECMO provides temporary respiratory and/or cardiac support to patients and is often considered when conventional treatment fails. The researchers examined the association between patients who survive after ECMO is used and postdischarge mental health diagnoses.

The researchers conducted a population-based retrospective cohort study from April 2010 through March 2020 with adult patients (n = 4462) who were admitted to the intensive care unit (ICU) and were eventually discharged by the hospital. Of the total, 642 patients received ECMO (mean age, 50.7 years) and had a median follow-up of 730 days. In total, 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 mental diagnosis following discharge that could be: a composite of mood disorders, anxiety disorders, posttraumatic stress disorder; schizophrenia, other psychotic disorders; other mental health disorders; and social problems. Of the total 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 condition.

Overall, the researchers found a 24% higher rate of new mental health diagnoses in patients who received ECMO when compared with ICU patients who did not receive ECMO. There was no significant association between substance postdischarge in people that 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 unsurprising given the invasive nature of critical care. Such diagnoses are the most common among all adult survivors of critical illness … this work provides important information for clinicians with regard to psychological supports for survivors following 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