ecls_run

This table stores information about the reason why a patient was put on ECLS.

Definition of a "run"

A run is defined as an exposure to ECLS thearpy and the beginning of blood flow through the circuit until the removal of the last cannula. This definition takes into account that patients can be left without support but cannulas are left in place to take them back on support quickly, if a long-term separation from the circuit is not successful.

Column name	Required	Data Type
run_id	True	integer, generated always as identity
start_datetime	True	timestamptz
stop_datetime	(True)	timestamptz
person_id	True	integer
visit_occurrence_id	True	integer
visit_detail_id		integer
urgency_concept_id	True	integer
start_reason_concept_id	True	integer
stop_reason_concept_id	(True)	integer

.run_id

The primary key column.

.start_datetime

Stores the timestamp of the beginning of the run. This is equivalent to the start of blood flow through the first circuit.

.stop_datetime

Denotes the stop of the run.

.person_id

The foreign key to the person table.

.visit_occurrence_id

The foreign key to the visit_occurrence table.

.visit_detail_id

The foreign key to the visit_detail table.

.urgency_concept_id

The foreign key to the concept table.
This attribute defines how urgent the initiation of ECLS was.

Allowed concepts:

concept_id	concept_code	concept_name
4093606	25876001	Emergency
4013731	103390000	Elective

.start_reason_concept_id

The foreign key to the concept table.
Patients can be put on ECLS for various reasons. Typical use cases are respiratory distress, cardiogenic shock, trauma or during resuscitation (ECPR). Use one of these concepts as main reason why a patient was put on ECLS. Child concepts might also be used.

Warning

Due to the nested structure of SNOMED CT some of the concepts might belong to multiple parent concepts and ex-post analysis whether the leading cause for ECLS was a traumatic injury might be difficult. Make sure to collect primary and secondary diagnoses accordingly and store them in the OMOP CDM condition_occurrence table.

For example, (90070003) Pneumothorax due to trauma (disorder) is a (320136) Disorder of respiratory system as well as (440921) Traumatic injury.

Extracorporeal cardiopulmonary resuscitation (ECPR)

ECPR is defined as the use of veno-arterial ECMO during cardiac arrest, where conventional CPR is stopped as soon as blood flow is established. For ECPR use the Resuscitation concept.

Allowed concepts (including child concepts):

concept_id	concept_code	concept_name
320136	50043002	Disorder of respiratory system
134057	49601007	Disorder of cardiovascular system
4205502	439569004	Resuscitation
440921	417746004	Traumatic injury

.stop_reason_concept_id

The foreign key to the concept table.
The run is stopped due to various reasons.

Allowed concepts:

concept_id	concept_name
4149524	Patient's condition improved
434489	Dead
4154766	Moribund
434263	Complication of extracorporeal circulation
4337306	Implantation of ventricular assist device
4272324	Cardiopulmonary bypass operation
4137127	Transplantation of heart
4337138	Transplant of lung
4138959	Heart-lung transplant with recipient cardiectomy-pneumonectomy

If the run was stopped completely because of a complication of an ECLS component, make sure to capture the respective complication. 434263, Complication of extracorporeal circulation serves as a high-level concept.

Death

If the patient dies, a respective entry in the OMOP CDM death table is necessary. Sometimes, ECLS support is withdrawn for a Moribund patient, because death is expected. The major difference between Dead and Moribund regarding data capture is the timestamp of death_datetime.

The patient dies "on ECMO" => Dead: death.death_datetime == ecls_run.stop_datetime
The patient is decannulated and dies shortly afterwards => Moribund: death.death_datetime > ecls_run.stop_datetime