Resident Physician Philadelphia, Pennsylvania, United States
Disclosure(s):
Syed Muhammad Saad Jalil, MD: No financial relationships to disclose
Background: VA-ECMO is typically used as a salvage therapy for refractory cardiogenic shock. The Survival After VenoArterial ECMO (SAVE) score is a commonly used prognostic tool designed to predict survival in this population. Here, we performed an external validation of the SAVE score in a single diverse tertiary care center.
Methods: We performed a retrospective single-center study of adult patients supported with VA-ECMO for refractory cardiogenic shock between 2020 and 2025. Patients undergoing VA-ECMO for indications other than cardiogenic shock, including extracorporeal cardiopulmonary resuscitation (ECPR), were excluded. A total of 67 eligible patients were included. The SAVE score was calculated for each patient. Discriminatory performance for in-hospital survival was assessed using receiver operating characteristic (ROC) curve analysis.
Outcome: Among 67 patients supported with VA-ECMO for refractory cardiogenic shock, the overall survival rate was 43% (29/67), in a racially diverse cohort in which 32 patients (48%) were Black. The SAVE score demonstrated good discrimination for in-hospital survival, with an area under the ROC curve (AUC) of 0.69 (95% confidence interval [CI] 0.56–0.82; p = 0.003).
Conclusion: In our single-center diverse cohort, the SAVE score demonstrated good discriminatory performance for predicting in-hospital survival among patients receiving VA-ECMO for refractory cardiogenic shock. These results support its utility as a prognostic tool to inform clinical decision-making in patients being considered for VA-ECMO support.
