Background. In most reports on ECMO treatment, advanced age is classified as a contraindication to VA ECMO. We attempted to investigate whether advanced age would be a main risk factor deciding VA ECMO application and performing VA ECMO support. We determined whether advanced age should be regarded as an absolute or relative contraindication to VA ECMO and could affect weaning and survival rates of VA ECMO patients. Methods. VA ECMO was performed on 135 adult patients with primary cardiogenic shock between January 2010 and December 2014. Successful weaning was defined as weaning from ECMO followed by survival for more than 48 hours. Results. Among the 135 patients, 35 survived and were discharged uneventfully, and the remaining 100 did not survive. There were significant differences in survival between age groups, and older age showed a lower survival rate with statistical significance (P = .01). By multivariate logistic regression analysis, age was not significantly associated with in-hospital mortality (P = .83) and was not significantly associated with VA ECMO weaning (P = .11). Conclusions. Advanced age is an undeniable risk factor for VA ECMO; however, patients of advanced age should not be excluded from the chance of recovery after VA ECMO treatment.
Time series data collected in clinical trials can have varying degrees of missingness, adding challenges during statistical analyses. An additional layer of complexity is introduced for missing data in randomized controlled trials (RCT), where researchers must remain blinded between intervention and control groups. Such restriction severely limits the applicability of conventional imputation methods that would utilize other participants’ data for improved performance. This paper explores and compares various methods to impute high-resolution temperature logger data in RCT settings. In addition to the conventional non-parametric approaches, we propose a spline regression (SR) approach that captures the dynamics of indoor temperature by time of day that is unique to each participant. We investigate how the inclusion of external temperature and energy use can improve the model performance. Results show that SR imputation results in 16% smaller root mean squared error (RMSE) compared to conventional imputation methods, with the gap widening to 22% when more than half of data is missing. The SR method is particularly useful in cases where missingness occurs simultaneously for multiple participants, such as concurrent battery failures. We demonstrate how proper modelling of periodic dynamics can lead to significantly improved imputation performance, even with limited data.
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