The clinical application value of SAVE,APACHEⅡ score combined with circulating biomarkers in predicting the 90 day survival prognosis of patients with AMICS treated with VA-ECMO
ZHOU Shu
YANG Shuhan
WANG Zengxia
WANG Xuening
FENG Ruihan
PENG Lili
YANG Meiling
Abstract：Objective Exploring the clinical application value of combining the Survival After Veno-Arterial Extracorporeal Membrane Oxygenation(SAVE)score,the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,and circulatory biomarkers in predicting 90-day survival outcomes in patients with acute myocardial infarction complicated by cardiogenic shock(AMICS)treated with veno-arterial extracorporeal mem-brane oxygenation(VA-ECMO).Methods A total of 136 patients with amics admitted to the hospital from Septem-ber 2020 to September 2024 were selected as the objects.All patients were treated with VA-ECMO,and were followed up for 90 days(the start time of follow-up was the day of VA-ECMO catheterization).The survival status of the patients was observed,and they were divided into survival group and death group according to the survival status.General clinical data,SAVE scores,APACHE Ⅱ scores,and levels of low-density lipoprotein(LDL),lactate,C-reactive protein(CRP),cardiac troponin 1(cTn1),and brain natriuretic peptide(BNP)were compared between the two groups.Multivariate Cox regression analysis was employed to identify factors influencing mortality in AMICS patients treated with VA-ECMO.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the clinical value of relevant indicators in predicting 90-day survival outcomes.Survival curves were generated using the Kaplan-Meier method,and the Log-rank test was used to compare survival differences between groups.Result Among 136 patients,a total of 63 died within 90 days,with a mortality rate of 46.32%;The death group was older than the survival group,with higher levels of APACHE Ⅱ score,low-density lipoprotein,lactate,CRP,cTn1,and BNP compared to the survival group,and lower levels of high-density lipoprotein and SAVE score compared to the survival group(P<0.05);Cox regression analysis showed that SAVE score,APACHEⅡ score,lactate,CRP,and cTn1 were all influencing factors for 90 day mortality in AMICS patients after VA-ECMO treatment(P<0.05);ROC curve analysis showed that the AUC value of the combined detection of SAVE score,APACHE Ⅱ score,lactate,CRP,and cTn1 in evaluating the 90 day mortality risk of VA-ECMO treatment for AMICS patients was higher than that of single detection(Z=5.731,3.573,5.544,5.983,4.807,P<0.05);Kaplan Meier curves showed that patients with SAVE score≤-4.301,APACHE Ⅱ score>25.076,lactate>3.900 mmol/L,CRP>23.752 mg/L,and cTn1>7.755 ng/mL had shorter survival times(Log rank chi square=16.573,4.028,61.746,22.375,28.635,P<0.001).Conclusion The combined detection of SAVE score,APACHE Ⅱ score,lactate,CRP,and cTn1 has a high efficacy in evaluating the 90 day mortality risk of VA-ECMO treatment for AMICS patients.
Keywords：SAVE ratingAcute Physiology and Chronic Health Status Score Ⅱcirculating biomarkerstransvenous arterial extracorporeal membrane oxygenationacute myocardial infarctioncardiogenic shock
Publication Date：2026-02-25
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：8( 698-705 )