Quality of life following extracorporeal membrane oxygenation (ECMO) therapy is an important health issue. We aimed to describe the characteristics of patients who developed chronic respiratory disease (CRD) following ECMO therapy, and investigate the association between newly diagnosed post-ECMO CRDs and 5-year all-cause mortality among ECMO survivors. We analyzed data from the National Health Insurance Service in South Korea. All adult patients who underwent ECMO therapy in the intensive care unit between 2006 and 2014 were included. ECMO survivors were defined as those who survived for 365 days after ECMO therapy. Chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease, lung cancer, lung disease due to external agents, obstructive sleep apnea, and lung tuberculosis were considered as CRDs. A total of 3055 ECMO survivors were included, and 345 (11.3%) were newly diagnosed with CRDs 365 days after ECMO therapy. The prevalence of asthma was the highest at 6.1% (185). In the multivariate logistic regression, ECMO survivors who underwent ECMO therapy for acute respiratory distress syndrome (ARDS) or respiratory failure had a 2.00-fold increase in post-ECMO CRD (95% confidence interval [CI]: 1.39 to 2.89; P < 0.001). In the multivariate Cox regression, newly diagnosed post-ECMO CRD was associated with a 1.47-fold (95% CI: 1.17 to 1.86; P = 0.001) higher 5-year all-cause mortality. At 12 months after ECMO therapy, 11.3% of ECMO survivors were newly diagnosed with CRDs. Patients who underwent ECMO therapy for ARDS or respiratory failure were associated with a higher incidence of newly diagnosed post-ECMO CRD compared to those who underwent ECMO for other causes. Additionally, post-ECMO CRDs were associated with a higher 5-year all-cause mortality. Our results suggest that ECMO survivors with newly diagnosed post-ECMO CRD might be a high-risk group requiring dedicated interventions.

中文翻译：

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体外膜肺氧合后的慢性呼吸系统疾病和生存结果

体外膜肺氧合 (ECMO) 治疗后的生活质量是一个重要的健康问题。我们旨在描述 ECMO 治疗后发展为慢性呼吸系统疾病 (CRD) 的患者的特征，并调查新诊断的 ECMO 后 CRD 与 ECMO 幸存者的 5 年全因死亡率之间的关联。我们分析了韩国国民健康保险局的数据。纳入了 2006 年至 2014 年间在重症监护病房接受 ECMO 治疗的所有成年患者。ECMO 存活者定义为 ECMO 治疗后存活 365 天的患者。慢性阻塞性肺病（COPD）、哮喘、间质性肺病、肺癌、外因引起的肺病、阻塞性睡眠呼吸暂停和肺结核被认为是 CRD。共纳入 3055 名 ECMO 幸存者，其中 345 名（11.3%）在 ECMO 治疗后 365 天被新诊断为 CRD。哮喘的患病率最高，为 6.1% (185)。在多变量逻辑回归中，因急性呼吸窘迫综合征 (ARDS) 或呼吸衰竭而接受 ECMO 治疗的 ECMO 幸存者在 ECMO 后 CRD 增加了 2.00 倍（95% 置信区间 [CI]：1.39 至 2.89；P < 0.001 ）。在多变量 Cox 回归中，新诊断的 ECMO 后 CRD 与 5 年全因死亡率高 1.47 倍（95% CI：1.17 至 1.86；P = 0.001）相关。在 ECMO 治疗后 12 个月时，11.3% 的 ECMO 幸存者被新诊断为 CRD。与因其他原因接受 ECMO 治疗的患者相比，因 ARDS 或呼吸衰竭接受 ECMO 治疗的患者新诊断出 ECMO 后 CRD 的发生率更高。此外，ECMO 后 CRD 与较高的 5 年全因死亡率相关。我们的结果表明，新诊断出的 ECMO 后 CRD 的 ECMO 幸存者可能是需要专门干预的高危人群。