TY  - JOUR
A1  - Weiß, Martin
A1  - Gründahl, Marthe
A1  - Deckert, Jürgen
A1  - Eichner, Felizitas A.
A1  - Kohls, Mirjam
A1  - Störk, Stefan
A1  - Heuschmann, Peter U.
A1  - Hein, Grit
T1  - Differential network interactions between psychosocial factors, mental health, and health-related quality of life in women and men
JF  - Scientific Reports
N2  - Psychosocial factors affect mental health and health-related quality of life (HRQL) in a complex manner, yet gender differences in these interactions remain poorly understood. We investigated whether psychosocial factors such as social support and personal and work-related concerns impact mental health and HRQL differentially in women and men during the first year of the COVID-19 pandemic. Between June and October 2020, the first part of a COVID-19-specific program was conducted within the “Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB)” cohort study, a representative age- and gender-stratified sample of the general population of Würzburg, Germany. Using psychometric networks, we first established the complex relations between personal social support, personal and work-related concerns, and their interactions with anxiety, depression, and HRQL. Second, we tested for gender differences by comparing expected influence, edge weight differences, and stability of the networks. The network comparison revealed a significant difference in the overall network structure. The male (N = 1370) but not the female network (N = 1520) showed a positive link between work-related concern and anxiety. In both networks, anxiety was the most central variable. These findings provide further evidence that the complex interplay of psychosocial factors with mental health and HRQL decisively depends on gender. Our results are relevant for the development of gender-specific interventions to increase resilience in times of pandemic crisis.
KW  - anxiety
KW  - depression
KW  - human behaviour
KW  - quality of life
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357858
VL  - 13
ER  - 
TY  - JOUR
A1  - Herrmann, Johannes
A1  - Lotz, Christopher
A1  - Karagiannidis, Christian
A1  - Weber-Carstens, Steffen
A1  - Kluge, Stefan
A1  - Putensen, Christian
A1  - Wehrfritz, Andreas
A1  - Schmidt, Karsten
A1  - Ellerkmann, Richard K.
A1  - Oswald, Daniel
A1  - Lotz, Gösta
A1  - Zotzmann, Viviane
A1  - Moerer, Onnen
A1  - Kühn, Christian
A1  - Kochanek, Matthias
A1  - Muellenbach, Ralf
A1  - Gaertner, Matthias
A1  - Fichtner, Falk
A1  - Brettner, Florian
A1  - Findeisen, Michael
A1  - Heim, Markus
A1  - Lahmer, Tobias
A1  - Rosenow, Felix
A1  - Haake, Nils
A1  - Lepper, Philipp M.
A1  - Rosenberger, Peter
A1  - Braune, Stephan
A1  - Kohls, Mirjam
A1  - Heuschmann, Peter
A1  - Meybohm, Patrick
T1  - Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation
JF  - Critical Care
N2  - Background
Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients.
Methods
673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival.
Results
Most patients were between 50 and 70 years of age. PaO\(_{2}\)/FiO\(_{2}\) ratio prior to ECMO was 72 mmHg (IQR: 58–99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41–0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28–1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events.
Conclusions
Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival.
KW  - Covid-19
KW  - extracorporeal membrane oxygenation (ECMO)
KW  - intensive care unit
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-299686
VL  - 26
IS  - 1
ER  -