Objective. We investigated the potential use of galectin-3 (Gal-3) as a prognostic indicator for patients with cardiogenic shock and developed a predictive mortality model for venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods. We prospectively studied patients (survivors and nonsurvivors) who received VA-ECMO for cardiogenic shock from 2019 to 2021. We recorded baseline data, Gal-3, and B-type natriuretic peptide (BNP) before ECMO and 24–72 h after ECMO. We used multivariable logistic regression to analyze significant risk factors and construct a VA-ECMO death prediction model. Receiver operating characteristic (ROC) curves were plotted to assess the predictive efficacy of the model. Results. We enrolled 73 patients with cardiogenic shock who received VA-ECMO support; 38 (52.05%) died in hospital. The median age was 57 years (interquartile range (IQR): 48–67 years); the median duration of ECMO therapy was 5.8 days (IQR: 4.62–7.57 days); and the median intensive care unit stay was 19.04 days (IQR: 13.92–26.15 days). Compared with the nonsurvivors, survivors had lower acute physiology and chronic health evaluation (APACHE) II scores ( < 0.001), increased left ventricular ejection fraction ( < 0.05), lower Gal-3 levels at 24 and 72 h (both  = 0.001), lower BNP levels at 24 and 72 h (both  = 0.001), and higher platelet counts ( = 0.009). Further multivariable analysis showed that APACHE II score, BNP-T72, and Gal-3-T72 were independent risk factors for death in VA-ECMO patients. Gal-3 and BNP were positively correlated ( < 0.05) and decreased significantly during ECMO treatment. The areas under the ROC curve (AUC) for APACHE II score, Gal-3-T72, and BNP-T72 were 0.687, 0.799, and 0.723, respectively. We constructed a combined prediction model with an AUC of 0.884 ( < 0.01). Conclusion. Gal-3 may serve as a prognostic indicator for patients receiving VA-ECMO for cardiogenic shock. The combined early warning score is a simple and effective tool for predicting mortality in VA-ECMO patients.

中文翻译：

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血清半乳糖凝集素 3 预测静脉动脉体外膜氧合患者的死亡率

客观的。我们研究了半乳糖凝集素 3 (Gal-3) 作为心源性休克患者预后指标的潜在用途，并开发了静脉动脉体外膜氧合 (VA-ECMO) 的预测死亡率模型。方法。我们前瞻性研究了 2019 年至 2021 年接受 VA-ECMO 治疗心源性休克的患者（幸存者和非幸存者）。我们记录了 ECMO 前和 ECMO 后 24-72 小时的基线数据、Gal-3 和 B 型利钠肽 (BNP)。我们使用多变量逻辑回归分析显着危险因素并构建 VA-ECMO 死亡预测模型。绘制受试者工作特征（ROC）曲线以评估模型的预测功效。结果。我们招募了 73 名接受 VA-ECMO 支持的心源性休克患者；38 人（52.05%）在医院死亡。中位年龄为 57 岁（四分位距 (IQR)：48-67 岁）；ECMO治疗的中位持续时间为5.8天（IQR：4.62-7.57天）；重症监护室住院时间中位数为 19.04 天（IQR：13.92-26.15 天）。与非幸存者相比，幸存者的急性生理学和慢性健康评估（APACHE）II评分较低（ <0.001），左心室射血分数增加（ <0.05），24小时和72小时时Gal-3水平较低（均 =0.001）， 24 小时和 72 小时时 BNP 水平较低（均 = 0.001），血小板计数较高（ = 0.009）。进一步多变量分析显示APACHE II评分、BNP-T72、Gal-3-T72是VA-ECMO患者死亡的独立危险因素。Gal-3和BNP呈正相关（ <0.05），并在ECMO治疗期间显着下降。APACHE II 评分、Gal-3-T72 和 BNP-T72 的 ROC 曲线下面积 (AUC) 分别为 0.687、0.799 和 0.723。我们构建了 AUC 为 0.884 (  < 0.01) 的组合预测模型。结论。Gal-3可以作为接受VA-ECMO治疗心源性休克的患者的预后指标。综合预警评分是预测 VA-ECMO 患者死亡率的简单而有效的工具。