Sex-Related Prognosis of VA-ECMO–Treated Cardiogenic Shock: A Post Hoc Analysis of the HYPO-ECMO Trial
Bibliographic record
Abstract
BACKGROUND: The sex-related prognosis of patients with cardiogenic shock undergoing venoarterial extracorporeal membrane oxygenation remains unclear. Our analyses aim to assess sex-specific outcomes in patients with cardiogenic shock receiving venoarterial extracorporeal membrane oxygenation and explore whether the effect of moderate hypothermia on clinical outcomes was modified by sex. METHODS: In this post hoc analysis of the HYPO-ECMO trial (Hypothermia During ECMO), clinical outcomes were compared by sex. The primary outcome was 30-day all-cause mortality. Key secondary outcomes included all-cause mortality and a composite outcome of all-cause mortality, heart transplant, escalation to left ventricular assist device implantation, or stroke at 30, 60, and 180 days. RESULTS: Among the 334 patients enrolled in the trial, 81 (24%) were female. At 30 days, 45.7% of female and 46.6% of male patients experienced the primary outcome, with no sex differences (adjusted odds ratio, 1.01 [0.57–1.78]; P =0.98 and log-rank test; P =0.93). No significant sex differences were observed in all-cause mortality at 60 and 180 days (adjusted odds ratio, 0.87 [0.49–1.52]; P =0.61 and 0.83 [0.47–1.46]; P =0.51, respectively) or in the composite outcome up to 180 days ( P >0.2 for all). The effect of moderate hypothermia on the primary outcome (adjusted odds ratio, 0.73 [0.43–1.25]; P =0.25 and 0.67 [0.26–1.76]; P =0.41, in male and female, respectively, interaction P =0.88) and secondary outcomes (interaction P >0.3 for all) was not modified by sex. CONCLUSIONS: In this post hoc analysis of the HYPO-ECMO trial, male and female patients experienced similar outcomes in cardiogenic shock treated with venoarterial extracorporeal membrane oxygenation. Sex did not significantly modify the effect of moderate hypothermia on outcomes. REGISTRATION: URL: https://clinicaltrials.gov/study/NCT02754193 ; Unique identifier: NCT02754193.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".