Resident Temple University Hospital philadelphia, Pennsylvania, United States
Disclosure(s):
Laya Manoj, MD: No financial relationships to disclose
Background: Racial and ethnic disparities have been observed among patients receiving VA-ECMO. Although mortality is similar across groups, Black patients may have higher rates of acute kidney injury. Prior studies are limited by homogenous, single-center cohorts. The need for renal replacement therapy remains a significant predictor of mortality in VA-ECMO patients.
Methods: We conducted a retrospective single-center study of 137 adults supported with VA-ECMO between 2020 and 2025. Patients were stratified by race (Black, White non-Hispanic, White Hispanic, Other) and RRT use. The primary outcome was mortality. Multivariable logistic regression included two models: a main effects model adjusting for race and RRT use, and an interaction model testing whether the effect of RRT on mortality differed by race. White non-Hispanic patients were the reference group.
Outcome: Overall mortality was 68.9% (93/137). Among those requiring RRT, mortality was 71.4% for Black patients, 85.2% for White non-Hispanic patients, and 75.0% for White Hispanic patients. In the main effects model, RRT was independently associated with higher odds of mortality (OR 3.85, 95% CI 1.89–7.84, p< 0.001). After adjusting for RRT, no significant racial differences in mortality were observed. The interaction model showed the effect of RRT on mortality did not differ significantly across racial groups, though small sample sizes, particularly White Hispanic (n=14) and Other (n=2), limited power.
Conclusion: Within a large single-center urban population, mortality amongst patients requiring VA-ECMO support was similar across racial and ethnic groups. RRT use was independently associated with higher mortality, and this effect did not vary by race.
