Long-term quality of life in adult extracorporeal membrane oxygenation survivors: A single-center, cross-sectional study

Long-term quality of life in adult extracorporeal membrane oxygenation survivors: A single-center, cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Long-term quality of life in adult extracorporeal membrane oxygenation survivors: A single-center, cross-sectional study Xiaoting Zeng, Fuxun Yang, Xiaoxiu Luo, Jiajia Li, Yunping Lan, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3990827/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 21 Nov, 2024 Read the published version in BMC Public Health → Version 1 posted 16 You are reading this latest preprint version Abstract Background: To understand the present situation of long-term quality of life of adult extracorporeal membrane oxygenation (ECMO) survivors, this study aimed to analyze and discuss the influencing factors and provide a reference for standardizing continuous nursing schemes for such patients. Methods: A cross-sectional survey was conducted by objective sampling using the General Information Questionnaire, 36-item short form health survey (SF-36), Barthel Index (BI), post-traumatic self-stress disorder rating scale (PTSD-SS), and Nottingham Health Profile part II (NHP-part II). A total of 106 adult ECMO survivors were included in the study. The quality of life, self-care ability, psychological state, and social adaptability of the patients were evaluated using investigative tools. A two-sample rank sum test or multi-sample Kruskal–Wallis test, Spearman correlation analysis, and multiple linear regression were used for statistical analysis. Results: This study’s results showed that the score of long-term quality of life in adult ECMO survivors was (63.72±20.87) and that of their mental health was (72.69±23.67). Physical health was positively correlated with the BI score (r=0.560, P < 0.01) and negatively correlated with the PTSD-SS (r=-0.58, P < 0.01) and NHP-part II score (r=-0.757, P < 0.01). Mental health was positively correlated with the BI score (r=0.589, P < 0.01) and negatively correlated with the post-traumatic stress disorder self-rating score (r=-0.741, P < 0.01) and NHP-part II score (r=-0.647, P < 0.01). Physical health content, caregiver type, on-the-job status, BI evaluation score, PTSD-SS, and NHP-part II score were independent influencing factors of quality of life (P < 0.05), which explained 82.6 % of the variability. The content dimensions of mental health, working status, residence, BI evaluation score, PTSD-SS, and the NHP-part-II score were independent influencing factors (P < 0.05), which explained 73.9 % of the variation. Conclusion: Surviving adult patients on ECMO have poor long-term quality of life and varying degrees of physical, psychological, and social dysfunction, with especially social functions that are in urgent need of restoration. Long-term quality of life is affected by many factors, including caregiver type, employment status, BI level, PTSD-SS level, NHP-part II level, and place of residence. A professional medical team is needed to establish ECMO professional clinics to provide more comprehensive and accurate care and improve the overall quality of life. extracorporeal membrane oxygenation critically ill patients long-term quality of life influencing factors Figures Figure 1 Background Extracorporeal membrane oxygenation (ECMO) is an extracorporeal life support technology that can completely or partially restore the function of the lungs and heart [ 1 ] . As of December 12, 2022, the official website data of the Extracorporeal Life Support Organization (ELSO) shows that ECMO treatment has accumulated > 188 000 cases globally, with a discharge survival rate of 54% [ 2 ] . However, patients treated with veno-venous extracorporeal membrane oxygenation (V-V ECMO), veno-arterial extracorporeal membrane oxygenation (V-A ECMO), and extracorporeal cardio-pulmonary resuscitation (ECPR) generally have critical conditions, long hospital stays, and high hospital costs; the discharge survival rate is generally low at 58%, 41%, and 29%, respectively, and the survival time is significantly shortened [ 3 ] . Enger et al. analyzed the prognosis of 553 severely ill patients treated with ECMO and found that the survival rates at one month, three months, one year and five years after discharge were 99%, 95%, 86%, and 76%, respectively. Among them, 41% died during follow-up, which was much higher than that in healthy people [ 4 ] . Von Bahr et al. conducted a retrospective study of 168 severe patients treated with ECMO and found that the period of high mortality was the first few months after the onset of disease, after which the mortality rate stabilized; therefore, 90 d could be used as the critical value for long-term survival [ 5 ] . With the increase of ECMO survivors, the high out-of-hospital mortality has gradually attracted people's attention, and an increasing number of experts and scholars have begun paying attention to the “full-chain” management of such patients. In particular, the health-related quality of life of survivors outside the hospital has gradually become a new research hotspot. However, there are few reports on such studies, and the few reported retrospective studies have found contradictory results [ 6 – 8 ] . In the retrospective study by Norkiene et al. [ 9 ] and Ørbo et al. [ 10 ] , ECMO did not affect the long-term health-related quality of life (HRQOL) of survivors, who were in good physical and mental state. The conclusion of the study by Wilcox [ 11 ] , Roll [ 12 ] , and others suggests that patients who have undergone ECMO treatment not only have a significant decrease in HRQOL, but also an increased probability of psychological trauma, which specifically manifests as anxiety, depression, and post-traumatic stress disorder. These different results may be related to the different intervention measures, follow-up, and post-intensive care unit (ICU) rehabilitation programs in different centers. Optimizing management during ICU stay, developing a good follow-up program, and providing post-ICU treatment to further optimize the management of patients with ECMO assistance are problems that need to be addressed to improve the survival rate of patients and allow them to return to normal life. Returning to society has significant social benefits and economic significance. This retrospective study mainly focused on the status quo and influencing factors of long-term quality of life of ECMO-assisted survival patients, through a stratified analysis of patients according to different regions; treatment levels; and social, economic, and cultural factors, to provide more references for the standardized nursing of surviving patients, and thus improve the quality of life of ECMO patients. Methods The method of cross-sectional surveys was adopted, and the survey period was from July 1, 2022 to October 31, 2022. Survey tools included: General Information Questionnaire, 36-item short form health survey (SF-36), Barthel Index (BI), post-traumatic self-stress disorder rating scale (PTSD-SS), and Nottingham Health Profile part II (NHP-part II). The quality of life, self-care ability, psychological state, and social adaptability of the patients were evaluated using investigative tools. 2.1 Patients Patients with long-term survival treated with ECMO in a high-volume ECMO center in Sichuan Province from January 2015 to July 2022 were selected as study participants. The inclusion criteria were as follows: (1) patients had been admitted to ICU and received ECMO treatment; (2) Age ≥ 18 years; (3) survival state was defined as survival and survival time was ≥ 90 d; (4) informed consent and voluntary participation were verified online or using telephone surveys. The exclusion criteria for participants were as follows: (1) history of mental illness and (2) severe psychological or cognitive dysfunction. The exclusion criteria also included: (1) questionnaires with < 1 min or < 2/3 of the items answered in the online questionnaire star survey and (2) patients who had not completed the assessment at the time of the telephone survey. There were 226 discharged patients in our center, and 106 participants met the inclusion criteria after telephone interviews. A screening flowchart of the questionnaire results is shown in Fig. 1 . 2.2 Data collection and quality control (1) Preparation and selection of measurement tools: The tools were developed after reviewing the literature, seeking advice from experts in related fields, preparation of demographic and clinical data questionnaires that meet the requirements of this study, and referring to other survey tools easy for the respondent to understand. (2) Training of investigators: The investigators were trained in the content of the investigation tools and methods, to enhance their communication skills, and to ensure the homogeneity of the investigation results. (3) Questionnaire completion: In this study, except for seven questionnaires filled online by the patients, the other 99 questionnaires were completed by the researcher through telephone interviews. Items that were unclear to the participants were explained by the researcher during the telephone interviews, and they were filled on the online website immediately after answering to ensure the authenticity and integrity of the data. (4) Data collation and analysis: Timely collation of questionnaire data, double checking, elimination of data that did not meet the requirements, and saving the original data for subsequent analysis and inspection were undertaken. 2.4 Statistical Methods In this study, SPSS 26.0 software was used for the statistical analysis of the collected data, the survey results were imported into Excel, the data were checked by two people, and invalid questionnaires were deleted according to the exclusion criteria. General data for frequency and composition comparisons were used for the statistical analysis. The measurement data conforming to a normal distribution are represented as mean ± standard deviation, whereas those not conforming to a normal distribution are represented as the median and interquartile interval M ( P25, P75 ). The measurement and questionnaire survey data in the general data were tested for normality. A t test and one-way analysis of variance were used for data conforming to a normal or approximately normal distribution. Two-sample rank sum test in the non-parametric test or multi-copy Kruskal-Wallis test was used for data that did not conform to a normal distribution. In the correlation analysis, Pearson or Spearman correlation analysis was used for inference, and the variables with statistical significance obtained from univariate and correlation analyses were used as independent variables, whereas multiple linear regression was used to analyze the influencing factors of quality of life in patients with severe ECMO. A test level of α = 0.05 and P < 0.05 were considered statistically significant. 2.5 Informed consent and ethical review This study followed the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Sichuan Provincial People's Hospital (approval number: 2022-91). All the participants provided informed consent. In compliance with confidentiality, the details of the participants are not provided. Results 3.1 Demographic and clinical data of patients A total of 106 participants were included in this study, with age ranging from 18 to 81 years and a mean age of (50.65 ± 13.82) years. This study included 76 men (71.70%) and 30 women (28.30%). The diagnoses and classifications of disease at admission are shown in Table 1 . Table 1 Patient demographic and clinical data (N = 106) Variable Paramete classification N n (%) Age(years) 18 ~ 30 11 10.40% 31 ~ 45 22 20.70% 46 ~ 65 54 51.00% ≥ 65 19 17.90% Sex Male 76 71.70% Female 30 28.30% Ethnic groups Han zu 101 95.3% Ethnic minority 5 4.70% Place of residence Towns 30 28.3% Country 25 23.60% City 51 48.10% Marital status Unmarried 7 6.60% married 86 81.13% divorced 6 5.67% Widowed 7 6.60% Educational level Primary and below 32 30.20% Junior high school 37 34.90% Senior high school 23 21.70% College or above 14 13.20% On-the-job status On the job 40 37.74% Dimission 1 0.94% retired 19 17.93% unemployed 46 43.39% Monthly income(RMB) 10000 23 21.69% Type of medical insurance The new rural cooperativemedical insurance system 56 52.80% The basic medical insurance for urban employees 36 34.00% The basic medicalinsurance system for urban residents 13 12.30% Poverty relief 1 0.90% Types of Caregiver Mate 38 35.80% Children or carers 16 15.10% Self-care 52 49.10% Genetic history Yes 14 13.20% No 92 86.80% Smoking Yes 8 7.50% No 98 92.50% Drinking Yes 25 23.60% No 81 76.40% Chronic disease Yes 43 40.60% No 63 59.40% BMI <18.5 8 7.50% 18.5 ~ 24.9 75 70.80% ≥ 25 23 21.70% Causes of ECMO Severe pneumonia 17 16.00% Severe myocarditis 16 15.10% Heart/lung transplant 10 9.40% shock 13 12.30% Myocardial infarction 16 15.10% Others 34 32.10% Length of discharge(months) 3–6 1 0.95% 6–12 7 6.60% 12–24 39 36.79% > 24 months 59 55.66% ECMO mode V-V ECMO 50 47.20% V-A ECMO 56 52.80% ECMO running time(days) 1–7 79 74.50% 8–14 23 21.70% >14 4 3.80% Ventilator time(days) 1–7 67 63.20% 8–14 28 26.40% >14 11 10.40% CRRT Yes 14 13.20% No 92 86.80% ICU stay time(days) 1–7 32 30.14% 8–14 36 34.00% 15–21 18 17.00% >21 20 18.86% Ecmo-related complications during hospitalization Hemorrhage 10 9.43% Lower limb ischemia (claudication) 2 1.89% Thromboembolism 3 2.83% Nervous system injury 3 2.83% Renal failure 2 1.89% 3.2 Research Tools The Cronbach’s α used in this study ranged from 0.866 to 0.966. The SF-36 Cronbach’s α was 0.866, the BI Cronbach's α was 0.947, the PTSD-SS Cronbach's α was 0.966, and the NHP-part II Cronbach's' α was 0.941. This indicates that the survey tools selected in this study had good reliability and validity. 3.3 Long-term quality of life status of adult ECMO survivors Through the investigation of long-term quality of life of severe patients treated with ECMO, we found that the scores of the physical health content (PCS) and mental health content (MCS) were (63.72 ± 20.87) points and (72.69 ± 23.67) points respectively, Compared with the results of the national population Quality of Life survey [ 13 ] , the scores of physical functioning, role-functioning physical, body pain, general health, vitality and role-emotion of severe patients treated by ECMO were lower, and the differences were statistically significant (P < 0.05), as shown in Table 2 . Table 2 SF-36 scores compared to national surveys Variable ECMO survivors (N = 106) national surveys (N = 749) t P PF 81.93 ± 22.34 97.56 ± 11.54 -11.28 <0.001 RP 33.96 ± 45.41 87.58 ± 26.58 -11.86 <0.001 BP 84.79 ± 13.28 81.18 ± 14.62 2.586 0.011 GH 54.18 ± 22.88 77.93 ± 15.87 -10.341 <0.001 VT 69.06 ± 19.78 73.10 ± 16.17 -2.010 0.047 SF 83.49 ± 21.93 83.14 ± 15.37 0.159 0.873 RE 61.64 ± 47.98 87.47 ± 31.35 -5.382 <0.001 MH 76.6 ± 18.63 76.25 ± 16.19 0.184 0.854 PCS 63.72 ± 20.87 - - - MCS 72.69 ± 23.67 - - - 3.4 Descriptive statistical results of other scales The survey results showed that the mean BI scores of the study participants was (96.17 ± 11.06), mean PTSD-SS scores was (36.64 ± 14.67), and mean NHP-part II scores was (4.05 ± 2.97), as shown in Table 3 . Table 3 The rest of the scale score(N = 106) Variable Theoretical score Conversion score \(\overline{x}\pm\) s BI 0 ~ 100 57 ~ 100 96.17 ± 11.06 PTSD-SS 24 ~ 120 24 ~ 97 36.64 ± 14.67 NHP-part II 0 ~ 7 0 ~ 7 4.05 ± 2.97 In terms of self-care ability, one patient (0.95%) was severely dependent, two patients (1.88%) were moderately dependent, 26 patients (24.52%) were mildly dependent, and 77 patients (72.65%) were not dependent. In the PTSD-SS scores, 18 cases (16.99%) had a high level of stress disorder and 88 cases (83.01%) had low levels of stress disorder. There were 46 cases (43.39%) with moderately low impact and 60 cases (56.61%) with high impact on the NHP-Part II scores, as shown in Tables 4 , 5 , and 6 . Table 4 BI level(N,%) Variable Heavily dependence (≤40) Moderate dependence (41~60) Mild dependence (61~99) No dependence (100) BI 1(0.95%) 2(1.88%) 26(24.52%) 77(72.65%) Table 5 PTSD-SS level(N,%) Variable Low level(<50) High level(≥50) PTSD-SS 88(83.01%) 18(16.99%) Table 6 NHP-part II level(N,%) Variable Low impact(<4) High impact(≥4) NHP-part II 46(43.39%) 60(56.61%) 3.5 Factors affecting long-term quality of life of severe patients treated with ECMO 3.5.1 Correlation analysis between quality of life and survey results of each scale The results showed that PCS was positively correlated with the BI score (r = 0.560, P < 0.01) and negatively correlated with the PTSD-SS and NHP-part II scores (r= -0.58 and − 0.757, respectively, P < 0.01). The MCS dimension of the quality of life score was positively correlated with the BI score, with a correlation coefficient of r = 0.589 (P < 0.01), and negatively correlated with the PTSD-SS and NHP-part II scores, with correlation coefficients of r= -0.741 and − 0.647 (P < 0.01), respectively (Table 7 ). Table 7 Correlation analysis of PCSand MCS dimension and scores of each scale PCS MCS BI PTSD-SS NHP-part II PCS 1 MCS 0.764** 1 BI 0.560** 0.589** 1 PTSD-SS -0.580** -0.741** -0.519** 1 NHP-part II -0.757** -0.647** -0.307** 0.492** 1 注: ** P <0.01。 3.5.2 Analysis of multiple factors affecting long-term quality of life of severe patients treated with ECMO In this study, statistically significant variables in the non-parametric test and correlation analysis were included in the multi-factor regression analysis. Independent variables were assigned values, and a multiple linear regression analysis was performed. First, the Tolerance and Variance inflation factor was used to test for multicollinearity in the regression equation. In the diagnosis of the model, the mean residual (1.17) was close to 0, the standard deviation (0.931) was close to 1, and the data were normally distributed. The scatter plot of the residual plot indicated that the data met the conditions of variance, homogeneity, and independence ( F = 22.283, P < 0.001), indicating that the model was statistically significant. The results showed that in the PCS dimension, caregiver type, on-the-job status, BI level, PTSD-SS level, and NHP-part II level were independent influencing factors (P < 0.05), and the adjusted R 2 = 0.826 was high with a good fit. In the MCS dimension, employment status, place of residence, BI level, PTSD-SS level, and NHP-part II level were independent influencing factors ( P < 0.05), and the adjusted R2 = 0.774 was at a high level with a good fit, as shown in Table 8 . Table 8 Results of multiple linear regression analysis Influencing factor B SE β t P Tolerance VIF PCS Variable 59.913 15.242 3.931 <0.001 Caregiver type= Children or carers -4.878 3.579 -0.084 -1.363 0.176 0.436 2.294 Caregiver type= companion -8.159 2.352 -0.188 -3.468 0.001 0.563 1.778 On-the-job status = dimission -18.821 9.148 -0.088 -2.057 0.043 0.915 1.092 On-the-job status = retire -10.776 3.308 -0.199 -3.258 0.002 0.445 2.248 On-the-job status = unemployed -10.979 2.64 -0.262 -4.159 <0.001 0.418 2.391 BI 0.447 0.096 0.237 4.672 <0.001 0.645 1.55 PTSD-SS -0.173 0.082 -0.122 -2.116 0.037 0.5 1.999 NHP-part II -2.8 0.39 -0.399 -7.171 <0.001 0.537 1.862 MCS Variable 43.799 16.293 2.688 0.009 On-the-job status = retire -8.762 4.038 -0.143 -2.17 0.033 0.574 1.741 On-the-job status = unemployed -6.911 3.541 -0.145 -1.951 0.054 0.447 2.236 On-the-job status = dimission 3.292 12.974 0.014 0.254 0.8 0.876 1.142 Place of Residence = village 4.437 3.532 0.08 1.256 0.212 0.613 1.631 Place of Residence = city 7.685 3.086 0.163 2.49 0.015 0.579 1.726 BI 0.505 0.135 0.236 3.752 <0.001 0.627 1.594 PTSD-SS -0.673 0.11 -0.417 -6.115 <0.001 0.534 1.874 NHP-part II -1.701 0.547 -0.213 -3.108 0.003 0.526 1.9 PCS: R = 0.852, R 2 = 0.826, F = 32.104, P <0.001; MCS: R = 0.774, R 2 = 0.739, F = 22.283, P <0.001。 Discussion The long-term quality of life of adult ECMO survivors must be improved. In this study, the long-term quality of life of adult ECMO survivors was lower with regards to the PCS dimension (65.35 ± 27.47 vs 63.72 ± 20.87) and higher in the MCS dimension (69.45 ± 27.87 vs 72.69 ± 23.67) than that of foreign ECMO-treated patients. This may be related to the patients’ follow-up time, sample size, demographic characteristics, and disease types. Compared with patients undergoing maintenance hemodialysis, patients treated with ECMO had a higher quality of life, and the scores of the PCS (56.84 ± 19.43 vs 63.72 ± 20.87) and MCS dimensions (50.63 ± 18.92 vs 72.69 ± 23.67) were both higher than those of the patients undergoing hemodialysis. This was consistent with the results reported by Spangenberg et al. [ 14 ] . This may be because patients undergoing maintenance hemodialysis need frequent hospital visits for treatment, whereas some patients treated with ECMO only need regular hospital visits after resolving the primary disease, and the burden of disease treatment is relatively low. In terms of self-care ability, 72.65% of patients did not need to rely on family members, which needs to be further improved compared with the 84.4% of patients who can take care of themselves completely, as reported by Benjamin [ 15 ] . Self-care ability depends on the presence of complications affecting daily life after discharge. In this study, the incidence of complications after catheterization was 18.9%, which included mainly lower limb ischemia, thromboembolism, nervous system injury, and chronic renal failure. Of these, bleeding and thromboembolism can be effectively controlled or solved during hospitalization; however, lower limb ischemia, nervous system injury, and chronic renal failure can persist in patients after discharge and even require lifelong treatment, which directly or indirectly affects the long-term quality of life of patients. In a meta-analysis [ 16 ] , the combined prevalence of late vascular complications of ECMO was found to be 8.1%. In our study, the combined prevalence of late vascular complications of ECMO was 4.72%. The decrease in vascular complications may be related to the active establishment of collateral circulation at our center for lower limb reperfusion to reduce or avoid the occurrence of lower limb ischemia. In terms of post-traumatic stress disorder, the incidence of high-level post-traumatic stress disorder in this study was 17.0%, which is lower than the 30.8% reported by Harley et al. [ 17 ] . This could be because the patients who were followed up in this study had been discharged from the hospital for more than three months, and their memory of ECMO events had decreased or blurred. With the companionship of family and gradual recovery from the disease, their psychological state tended to be stable. In terms of social function, 56.6% of the patients in this study had impaired social function, and only 37.7% of the patients were working, whereas in the study by Rilinger [ 18 ] , patients with VV-ECMO reached an 80% in-service rate. Patients in our center had a relatively low in-service rate because they were mixed with patients on VA-ECMO. Conversely, our incumbency rate excluded nearly 20% of retirees. In our study, 38% and 37.5% of patients treated with the V-V and V-A modes were on duty, respectively. This result is consistent with those of previous studies [ 19 , 20 ] . In the multifactor analysis affecting the long-term quality of life of severely ill patients treated with ECMO, the type of caregiver was an independent factor influencing the PCS dimension. When the caregiver was the spouse, the patient's quality of life score was lower, which may be related to the fact that the patient's physical function had not recovered, the patient needed extra help, and the spouse was the closest family member. Moreover, under greater care pressure, when patients feel dual physical and psychological pressure, they will experience more negative emotions. In-service status after discharge was an independent factor affecting the two dimensions of quality of life. The quality of life of patients with an on-the-job status is significantly higher than that of patients who leave their jobs, retire, or lose their jobs. When patients recover physically and participate in social work, their physical and psychological recovery can be promoted. The degree of participation in social activities had a significant positive correlation with quality of life, which is consistent with the results of Hsieh et al. [ 21 ] . In addition, the quality of life of patients living in cities is higher, which may be related to better medical conditions, a more convenient life, and a better material basis. BI, PTSD-SS, and NHP-part II scores of patients were significantly correlated with quality of life and better self-care ability; lower post-traumatic stress disorder and lower impaired social function could predict a better quality of life. 4.1 Limitations and prospects This study has some limitations. This was a single-center study, and there may be some limitations in the selection of samples. This study only investigated the long-term quality of life of some patients in a single center, and the results were regional. In the future, a multicenter national survey should be conducted to better understand the long-term quality of life of severely ill patients treated with ECMO in China. This study was designed to investigate patients who have been discharged from the hospital for more than three months, and there is a lack of data on the prospective investigation of patients within three months of discharge; therefore, a prospective scientific study should be carried out at a later stage to supplement the lack of current data on patients' quality of life within three months of discharge. Conclusions In general, the long-term quality of life of adult ECMO survivors is poor, and there are different degrees of physiological, psychological, and social dysfunctions, especially regarding the urgent need to restore social function. Long-term quality of life is affected by a variety of factors. It may be necessary for professional medical teams to conduct long-term management of chronic diseases by setting up ECMO professional outpatient clinics, online follow-up, offline family follow-up, and other methods to provide more comprehensive and accurate care, improve the long-term quality of life as a whole, and extend the survival period of survivors. Abbreviations BI Barthel Index (BI) BP Body pain ECPR Extracorporeal cardiopulmonary resuscitation (ECPR) ECMO Extracorporeal membrane oxygenation ELSO Extracorporeal Life Support Organization (ELSO) GUH General health HRQOL Health-related quality of life ICU Intensive care unit MCS Mental health content NHP part II Nottingham Health Profile part II . SF-36, 36-item short form health survey (SF-36) PCS Physical health content PF- Physical functioning PTSD Post-traumatic self-stress disorder rating scale (PTSD-SS), RE Role emotion VT Vitality V-V ECMO Veno-venous Extracorporeal membrane oxygenation V-A ECMO Veno-arterial Extracorporeal membrane oxygenation Declarations Ethics Approval and Consent to Participate This study followed the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Sichuan Provincial People's Hospital (approval number: 2022-91). All the participants provided informed consent. In compliance with confidentiality, the details of the participants were not provided. Consent for Publication Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Availability of Data and Materials The dataset used and/or analyzed during the current study is available from the corresponding author on reasonable request. Competing interests We declare that we have no competing interests. Funding No funding. Authors’ contributions F.Y.,X.Z.,C.P.,R.L.and X.H. conceived the study and took responsibility for the integrity of the study. X.L. and J.L. joined in study design, data analysis, data interpretation, and manuscript preparation. Y.L, F.Z, Y.L.joined in patient screening, data collection, data management, data interpretation, and revised the manuscript. All authors contributed to the intellectual content of the manuscript and approved the final version submitted for publication. Acknowledgments Thanks to all the interviewees for their active cooperation. References Ficial B, Vasques F, Zhang J, Whebell S, Slattery M, Lamas T, et al. Physiological basis of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal in respiratory failure. Membranes (Basel) . 2021;11. https://doi.org/10.3390/membranes11030225 Extracorporeal Life Support Organization | ELSO | ECMO[EB/OL].2022-12-12,https://www.elso.org/. Thiagarajan RR, Barbaro RP, Rycus PT, McMullan DM, Conrad SA, Fortenberry JD, et al. Extracorporeal life support organization registry international report 2016. ASAIO J . 2017;63:60–7. https://doi.org/10.1097/MAT.0000000000000475 Enger TB, Philipp A, Lubnow M, Fischer M, Camboni D, Lunz D, et al. Long-term survival in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation. Crit Care Med . 2017;45:1718–25. https://doi.org/10.1097/CCM.0000000000002644 von Bahr V, Hultman J, Eksborg S, Frenckner B, Kalzén H. Long-term survival in adults treated with extracorporeal membrane oxygenation for respiratory failure and sepsis. Crit Care Med . 2017;45:164–70. https://doi.org/10.1097/CCM.0000000000002078 Tiedebohl JM, DeFabio ME, Bell T, Buchko BL, Woods AB. ECMO survivors’ quality of life and needs after discharge: A descriptive, comparative cross-sectional pilot study. Intensive Crit Care Nurs . 2020;59:102829. https://doi.org/10.1016/j.iccn.2020.102829 Sanfilippo F, Ippolito M, Santonocito C, Martucci G, Carollo T, Bertani A , et al. Long-term functional and psychological recovery in a population of acute respiratory distress syndrome patients treated with VV-ECMO and in their caregivers. Minerva Anestesiol . 2019;85:971–80. https://doi.org/10.23736/S0375-9393.19.13095-7 Galazzi A, Brambilla A, Grasselli G, Pesenti A, Fumagalli R, Lucchini A. Quality of life of adult survivors after extra corporeal membrane oxygenation (ECMO): A quantitative study. Dimens Crit Care Nurs . 2018;37:12–7. https://doi.org/10.1097/DCC.0000000000000278 Norkiene I, Jovaisa T, Scupakova N, Janusauskas V, Rucinskas K, Serpytis P, et al. Long-term quality of life in patients treated with extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock. Perfusion . 2019;34:285–9. https://doi.org/10.1177/0267659118815291 Ørbo MC, Karlsen SF, Pedersen EP, Hermansen SE, Rønning PB, Nergaard KA, et al. Health-related quality of life after extracorporeal membrane oxygenation: A single centre’s experience. ESC Heart Fail . 2019;6:701–10. https://doi.org/10.1002/ehf2.12433 Wilcox ME, Jaramillo-Rocha V, Hodgson C, Taglione MS, Ferguson ND, Fan E. Long-term quality of life after extracorporeal membrane oxygenation in ARDS survivors: Systematic review and meta-analysis. J Intensive Care Med . 2020;35:233–43. https://doi.org/10.1177/0885066617737035 Roll MA, Kuys S, Walsh JR, Tronstad O, Ziegenfuss MD, Mullany DV. Long-term survival and health-related quality of life in adults after extra corporeal membrane oxygenation. Heart Lung Circ . 2019;28:1090–8. https://doi.org/10.1016/j.hlc.2018.06.1044 Rui W, Cheng W, Ma XQ, Zhao YF, Yan XY, Jia H. Health-related quality of life in Chinese people: A population-based survey of five cities in China. Scand J Public Health . 2011;39:410–8. https://doi.org/10.1177/1403494810395817 Spangenberg T, Schewel J, Dreher A, Meincke F, Bahlmann E, van der Schalk H , et al. Health related quality of life after extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest. Resuscitation . 2018;127:73–8. https://doi.org/10.1016/j.resuscitation.2018.03.036 Immohr MB, Eschlböck SM, Rellecke P, Dalyanoglu H, Tudorache I, Boeken U, et al. The quality of afterlife: Surviving extracorporeal life support after therapy-refractory circulatory failure-a comprehensive follow-up analysis. ESC Heart Fail. 2021;8:4968–75. https://doi.org/10.1002/ehf2.13554 Jia D, Yang IX, Ling RR, Syn N, Poon WH, Murughan K, et al. Vascular complications of extracorporeal membrane oxygenation: A systematic review and meta-regression analysis. Crit Care Med . 2020;48:e1269–77-e1277. https://doi.org/10.1097/CCM.0000000000004688 Harley O, Reynolds C, Nair P, Buscher H. Long-Term Survival, Posttraumatic Stress, and Quality of Life post Extracorporeal Membrane Oxygenation. ASAIO J . 2020;66:909–14. https://doi.org/10.1097/MAT.0000000000001095 Rilinger J, Krötzsch K, Bemtgen X, Jäckel M, Zotzmann V, Lang CN , et al. Long-term survival and health-related quality of life in patients with severe acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation support. Crit Care . 2021;25:410. https://doi.org/10.1186/s13054-021-03821-0 Stadlbauer A, Philipp A, Blecha S, Lubnow M, Lunz D, Li J, et al. Long-term follow-up and quality of life in patients receiving extracorporeal membrane oxygenation for pulmonary embolism and cardiogenic shock. Ann Intensive Care . 2021;11:181. https://doi.org/10.1186/s13613-021-00975-6 Chommeloux J, Valentin S, Winiszewski H, Adda M, Pineton de Chambrun M, Moyon Q , et al. One-year mental and physical health assessment in survivors after extracorporeal membrane oxygenation for COVID-19-related acute respiratory distress syndrome. Am J Respir Crit Care Med . 2023;207:150–9. https://doi.org/10.1164/rccm.202206-1145OC Hsieh FT, Huang GS, Ko WJ, Lou MF. Health status and quality of life of survivors of extra corporeal membrane oxygenation: A cross-sectional study. J Adv Nurs . 2016;72:1626–37. https://doi.org/10.1111/jan.12943 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3990827","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":277643890,"identity":"bfc42865-add9-4ab5-89e6-e14347c22ee5","order_by":0,"name":"Xiaoting Zeng","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xiaoting","middleName":"","lastName":"Zeng","suffix":""},{"id":277643891,"identity":"19bcc303-6b31-4334-a16b-864b1a5065ca","order_by":1,"name":"Fuxun Yang","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fuxun","middleName":"","lastName":"Yang","suffix":""},{"id":277643892,"identity":"fc54d790-f23d-48c7-b907-3de4e0b57e15","order_by":2,"name":"Xiaoxiu Luo","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xiaoxiu","middleName":"","lastName":"Luo","suffix":""},{"id":277643893,"identity":"1c6374ed-10b0-416d-84ba-2f26d289bf1c","order_by":3,"name":"Jiajia Li","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jiajia","middleName":"","lastName":"Li","suffix":""},{"id":277643894,"identity":"cbce6fd6-7484-46f7-8e4a-c21709a63d76","order_by":4,"name":"Yunping Lan","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yunping","middleName":"","lastName":"Lan","suffix":""},{"id":277643895,"identity":"0f0900fa-d7de-49e7-841b-8dac60d3da13","order_by":5,"name":"Fan Zeng","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Fan","middleName":"","lastName":"Zeng","suffix":""},{"id":277643896,"identity":"36795f6c-394c-4dd4-9653-08a55640f4c2","order_by":6,"name":"Yu Lei","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Yu","middleName":"","lastName":"Lei","suffix":""},{"id":277643898,"identity":"3464ec77-dedc-43ef-a142-6d46f4db1aff","order_by":7,"name":"Chun Pan","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chun","middleName":"","lastName":"Pan","suffix":""},{"id":277643900,"identity":"a5b69763-cf78-4121-a24d-91b73cd3089e","order_by":8,"name":"Rongan Liu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwUlEQVRIiWNgGAWjYBACefnDx398qGDj4Sdai+EMtgTJGWf45CQbiNZzg8dAmrdNztjgALE6GGc3GBjzsJklbj6evIHhR8U2wlrYZQ4kJM7hSUvcduZZAWPPmdtE2NKQcODAG4ljidtu5BgwM7YRoYXhQGJjA4/B/8TNM4jWciOZmZEngc3YQIJYLYY9x9gYZxxgk5MA+uUgUX6RZ+//xvDxHzAq25M3PvhRQYzDECCB+KhBaCFVxygYBaNgFIwQAACOHz+fb7/6FwAAAABJRU5ErkJggg==","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Rongan","middleName":"","lastName":"Liu","suffix":""},{"id":277643904,"identity":"32b78a7a-2586-49df-b61b-de2c0159faf4","order_by":9,"name":"Xiaobo Huang","email":"","orcid":"","institution":"University of Electronic Science and Technology of China","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xiaobo","middleName":"","lastName":"Huang","suffix":""}],"badges":[],"createdAt":"2024-02-26 11:49:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3990827/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3990827/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-024-20782-5","type":"published","date":"2024-11-21T15:58:07+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":52540666,"identity":"38b3fc02-de09-4bca-ac78-cc46f5037468","added_by":"auto","created_at":"2024-03-12 17:23:20","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":33836,"visible":true,"origin":"","legend":"\u003cp\u003eScreening process table\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3990827/v1/780e1d384c961d5c1785f4c1.jpg"},{"id":69835438,"identity":"89ffff74-f03b-42ab-9db8-7688f7b5593d","added_by":"auto","created_at":"2024-11-25 16:13:27","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1014089,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3990827/v1/31d9722a-d672-4a23-85ae-59371649f1f4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Long-term quality of life in adult extracorporeal membrane oxygenation survivors: A single-center, cross-sectional study","fulltext":[{"header":"Background","content":"\u003cp\u003eExtracorporeal membrane oxygenation (ECMO) is an extracorporeal life support technology that can completely or partially restore the function of the lungs and heart \u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e. As of December 12, 2022, the official website data of the Extracorporeal Life Support Organization (ELSO) shows that ECMO treatment has accumulated\u0026thinsp;\u0026gt;\u0026thinsp;188 000 cases globally, with a discharge survival rate of 54%\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e. However, patients treated with veno-venous extracorporeal membrane oxygenation (V-V ECMO), veno-arterial extracorporeal membrane oxygenation (V-A ECMO), and extracorporeal cardio-pulmonary resuscitation (ECPR) generally have critical conditions, long hospital stays, and high hospital costs; the discharge survival rate is generally low at 58%, 41%, and 29%, respectively, and the survival time is significantly shortened \u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e. Enger et al. analyzed the prognosis of 553 severely ill patients treated with ECMO and found that the survival rates at one month, three months, one year and five years after discharge were 99%, 95%, 86%, and 76%, respectively. Among them, 41% died during follow-up, which was much higher than that in healthy people \u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e. Von Bahr et al. conducted a retrospective study of 168 severe patients treated with ECMO and found that the period of high mortality was the first few months after the onset of disease, after which the mortality rate stabilized; therefore, 90 d could be used as the critical value for long-term survival \u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003e. With the increase of ECMO survivors, the high out-of-hospital mortality has gradually attracted people's attention, and an increasing number of experts and scholars have begun paying attention to the \u0026ldquo;full-chain\u0026rdquo; management of such patients. In particular, the health-related quality of life of survivors outside the hospital has gradually become a new research hotspot. However, there are few reports on such studies, and the few reported retrospective studies have found contradictory results \u003csup\u003e[\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e. In the retrospective study by Norkiene et al. \u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e and \u0026Oslash;rbo et al. \u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e, ECMO did not affect the long-term health-related quality of life (HRQOL) of survivors, who were in good physical and mental state. The conclusion of the study by Wilcox \u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e, Roll \u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e, and others suggests that patients who have undergone ECMO treatment not only have a significant decrease in HRQOL, but also an increased probability of psychological trauma, which specifically manifests as anxiety, depression, and post-traumatic stress disorder.\u003c/p\u003e \u003cp\u003eThese different results may be related to the different intervention measures, follow-up, and post-intensive care unit (ICU) rehabilitation programs in different centers. Optimizing management during ICU stay, developing a good follow-up program, and providing post-ICU treatment to further optimize the management of patients with ECMO assistance are problems that need to be addressed to improve the survival rate of patients and allow them to return to normal life. Returning to society has significant social benefits and economic significance. This retrospective study mainly focused on the status quo and influencing factors of long-term quality of life of ECMO-assisted survival patients, through a stratified analysis of patients according to different regions; treatment levels; and social, economic, and cultural factors, to provide more references for the standardized nursing of surviving patients, and thus improve the quality of life of ECMO patients.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe method of cross-sectional surveys was adopted, and the survey period was from July 1, 2022 to October 31, 2022. Survey tools included: General Information Questionnaire, 36-item short form health survey (SF-36), Barthel Index (BI), post-traumatic self-stress disorder rating scale (PTSD-SS), and Nottingham Health Profile part II (NHP-part II). The quality of life, self-care ability, psychological state, and social adaptability of the patients were evaluated using investigative tools.\u003c/p\u003e\n\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1 Patients\u003c/h2\u003e\n \u003cp\u003ePatients with long-term survival treated with ECMO in a high-volume ECMO center in Sichuan Province from January 2015 to July 2022 were selected as study participants. The inclusion criteria were as follows: (1) patients had been admitted to ICU and received ECMO treatment; (2) Age\u0026thinsp;\u0026ge;\u0026thinsp;18 years; (3) survival state was defined as survival and survival time was \u0026ge;\u0026thinsp;90 d; (4) informed consent and voluntary participation were verified online or using telephone surveys. The exclusion criteria for participants were as follows: (1) history of mental illness and (2) severe psychological or cognitive dysfunction. The exclusion criteria also included: (1) questionnaires with \u0026lt;\u0026thinsp;1 min or \u0026lt;\u0026thinsp;2/3 of the items answered in the online questionnaire star survey and (2) patients who had not completed the assessment at the time of the telephone survey. There were 226 discharged patients in our center, and 106 participants met the inclusion criteria after telephone interviews. A screening flowchart of the questionnaire results is shown in Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003e2.2 Data collection and quality control\u003c/h2\u003e\n \u003cp\u003e(1) Preparation and selection of measurement tools: The tools were developed after reviewing the literature, seeking advice from experts in related fields, preparation of demographic and clinical data questionnaires that meet the requirements of this study, and referring to other survey tools easy for the respondent to understand.\u003c/p\u003e\n \u003cp\u003e(2) Training of investigators: The investigators were trained in the content of the investigation tools and methods, to enhance their communication skills, and to ensure the homogeneity of the investigation results.\u003c/p\u003e\n \u003cp\u003e(3) Questionnaire completion: In this study, except for seven questionnaires filled online by the patients, the other 99 questionnaires were completed by the researcher through telephone interviews. Items that were unclear to the participants were explained by the researcher during the telephone interviews, and they were filled on the online website immediately after answering to ensure the authenticity and integrity of the data.\u003c/p\u003e\n \u003cp\u003e(4) Data collation and analysis: Timely collation of questionnaire data, double checking, elimination of data that did not meet the requirements, and saving the original data for subsequent analysis and inspection were undertaken.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003e2.4 Statistical Methods\u003c/h2\u003e\n \u003cp\u003eIn this study, SPSS 26.0 software was used for the statistical analysis of the collected data, the survey results were imported into Excel, the data were checked by two people, and invalid questionnaires were deleted according to the exclusion criteria. General data for frequency and composition comparisons were used for the statistical analysis. The measurement data conforming to a normal distribution are represented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, whereas those not conforming to a normal distribution are represented as the median and interquartile interval \u003cem\u003eM\u003c/em\u003e (\u003cem\u003eP25, P75\u003c/em\u003e). The measurement and questionnaire survey data in the general data were tested for normality. A \u003cem\u003et\u003c/em\u003e test and one-way analysis of variance were used for data conforming to a normal or approximately normal distribution. Two-sample rank sum test in the non-parametric test or multi-copy Kruskal-Wallis test was used for data that did not conform to a normal distribution. In the correlation analysis, Pearson or Spearman correlation analysis was used for inference, and the variables with statistical significance obtained from univariate and correlation analyses were used as independent variables, whereas multiple linear regression was used to analyze the influencing factors of quality of life in patients with severe ECMO. A test level of \u0026alpha;\u0026thinsp;=\u0026thinsp;0.05 and P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant.\u003c/p\u003e\n \u003ch2\u003e\u003cstrong\u003e2.5 Informed consent\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eand ethical review\u003c/strong\u003e\u003c/h2\u003e\n \u003cp\u003eThis study followed the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Sichuan Provincial People\u0026apos;s Hospital (approval number: 2022-91). All the participants provided informed consent. In compliance with confidentiality, the details of the participants are not provided.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Demographic and clinical data of patients\u003c/h2\u003e \u003cp\u003eA total of 106 participants were included in this study, with age ranging from 18 to 81 years and a mean age of (50.65\u0026thinsp;\u0026plusmn;\u0026thinsp;13.82) years. This study included 76 men (71.70%) and 30 women (28.30%). The diagnoses and classifications of disease at admission are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatient demographic and clinical data (N\u0026thinsp;=\u0026thinsp;106)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParamete classification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en\u0026nbsp;(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026thinsp;~\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026thinsp;~\u0026thinsp;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.70%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u0026thinsp;~\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.00%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.90%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.70%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthnic groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHan zu\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e95.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEthnic minority\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.70%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of residence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTowns\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCountry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81.13%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003edivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.67%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary and below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJunior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.90%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSenior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.70%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollege or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn-the-job status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOn the job\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.74%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDimission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.94%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eretired\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.93%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eunemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.39%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly income(RMB)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;5000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.79%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5000\u0026thinsp;~\u0026thinsp;8000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.97%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8000\u0026thinsp;~\u0026thinsp;10000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.55%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;10000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.69%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType of medical insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe new rural cooperativemedical insurance system\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.80%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe basic medical insurance for urban employees\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.00%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe basic medicalinsurance system for urban residents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoverty relief\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.90%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTypes of Caregiver\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.80%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChildren or carers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGenetic history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.80%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e92.50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.5\u0026thinsp;~\u0026thinsp;24.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e70.80%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.70%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCauses of ECMO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSevere pneumonia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.00%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSevere myocarditis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeart/lung transplant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eshock\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.30%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMyocardial infarction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.10%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of discharge(months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.95%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.79%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;24 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e55.66%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECMO mode\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eV-V ECMO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eV-A ECMO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.80%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eECMO running time(days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e74.50%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.70%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.80%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVentilator time(days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e26.40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRRT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.20%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.80%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eICU stay time(days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.14%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.00%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.00%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.86%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEcmo-related complications during hospitalization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHemorrhage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.43%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLower limb ischemia (claudication)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.89%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThromboembolism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.83%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNervous system injury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.83%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRenal failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.89%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Research Tools\u003c/h2\u003e \u003cp\u003eThe Cronbach\u0026rsquo;s α used in this study ranged from 0.866 to 0.966. The SF-36 Cronbach\u0026rsquo;s α was 0.866, the BI Cronbach's α was 0.947, the PTSD-SS Cronbach's α was 0.966, and the NHP-part II Cronbach's' α was 0.941. This indicates that the survey tools selected in this study had good reliability and validity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Long-term quality of life status of adult ECMO survivors\u003c/h2\u003e \u003cp\u003eThrough the investigation of long-term quality of life of severe patients treated with ECMO, we found that the scores of the physical health content (PCS) and mental health content (MCS) were (63.72\u0026thinsp;\u0026plusmn;\u0026thinsp;20.87) points and (72.69\u0026thinsp;\u0026plusmn;\u0026thinsp;23.67) points respectively, Compared with the results of the national population Quality of Life survey \u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e, the scores of physical functioning, role-functioning physical, body pain, general health, vitality and role-emotion of severe patients treated by ECMO were lower, and the differences were statistically significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSF-36 scores compared to national surveys\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eECMO survivors\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;106)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003enational surveys\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;749)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e81.93\u0026thinsp;\u0026plusmn;\u0026thinsp;22.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97.56\u0026thinsp;\u0026plusmn;\u0026thinsp;11.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-11.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e33.96\u0026thinsp;\u0026plusmn;\u0026thinsp;45.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87.58\u0026thinsp;\u0026plusmn;\u0026thinsp;26.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-11.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e84.79\u0026thinsp;\u0026plusmn;\u0026thinsp;13.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.18\u0026thinsp;\u0026plusmn;\u0026thinsp;14.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.586\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e54.18\u0026thinsp;\u0026plusmn;\u0026thinsp;22.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77.93\u0026thinsp;\u0026plusmn;\u0026thinsp;15.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-10.341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e69.06\u0026thinsp;\u0026plusmn;\u0026thinsp;19.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73.10\u0026thinsp;\u0026plusmn;\u0026thinsp;16.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e83.49\u0026thinsp;\u0026plusmn;\u0026thinsp;21.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83.14\u0026thinsp;\u0026plusmn;\u0026thinsp;15.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.873\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e61.64\u0026thinsp;\u0026plusmn;\u0026thinsp;47.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87.47\u0026thinsp;\u0026plusmn;\u0026thinsp;31.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-5.382\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e76.6\u0026thinsp;\u0026plusmn;\u0026thinsp;18.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76.25\u0026thinsp;\u0026plusmn;\u0026thinsp;16.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.854\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e63.72\u0026thinsp;\u0026plusmn;\u0026thinsp;20.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e72.69\u0026thinsp;\u0026plusmn;\u0026thinsp;23.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Descriptive statistical results of other scales\u003c/h2\u003e \u003cp\u003eThe survey results showed that the mean BI scores of the study participants was (96.17\u0026thinsp;\u0026plusmn;\u0026thinsp;11.06), mean PTSD-SS scores was (36.64\u0026thinsp;\u0026plusmn;\u0026thinsp;14.67), and mean NHP-part II scores was (4.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97), as shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe rest of the scale score(N\u0026thinsp;=\u0026thinsp;106)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eTheoretical score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConversion score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\overline{x}\\pm\\)\u003c/span\u003e\u003c/span\u003e\u003cem\u003es\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026thinsp;~\u0026thinsp;100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57\u0026thinsp;~\u0026thinsp;100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e96.17\u0026thinsp;\u0026plusmn;\u0026thinsp;11.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePTSD-SS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u0026thinsp;~\u0026thinsp;120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24\u0026thinsp;~\u0026thinsp;97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36.64\u0026thinsp;\u0026plusmn;\u0026thinsp;14.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNHP-part II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026thinsp;~\u0026thinsp;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026thinsp;~\u0026thinsp;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.05\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn terms of self-care ability, one patient (0.95%) was severely dependent, two patients (1.88%) were moderately dependent, 26 patients (24.52%) were mildly dependent, and 77 patients (72.65%) were not dependent. In the PTSD-SS scores, 18 cases (16.99%) had a high level of stress disorder and 88 cases (83.01%) had low levels of stress disorder. There were 46 cases (43.39%) with moderately low impact and 60 cases (56.61%) with high impact on the NHP-Part II scores, as shown in Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, and \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBI level(N,%)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeavily dependence\u003c/p\u003e \u003cp\u003e(\u0026le;40)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eModerate dependence\u003c/p\u003e \u003cp\u003e(41~60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMild dependence\u003c/p\u003e \u003cp\u003e(61~99)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo dependence\u003c/p\u003e \u003cp\u003e(100)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0.95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(1.88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26(24.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77(72.65%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePTSD-SS level(N,%)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow level(\u0026lt;50)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh level(\u0026ge;50)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTSD-SS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88(83.01%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18(16.99%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNHP-part II level(N,%)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow impact(\u0026lt;4)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh impact(\u0026ge;4)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNHP-part II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46(43.39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60(56.61%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Factors affecting long-term quality of life of severe patients treated with ECMO\u003c/h2\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e3.5.1 Correlation analysis between quality of life and survey results of each scale\u003c/h2\u003e \u003cp\u003eThe results showed that PCS was positively correlated with the BI score (r\u0026thinsp;=\u0026thinsp;0.560, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01) and negatively correlated with the PTSD-SS and NHP-part II scores (r= -0.58 and \u0026minus;\u0026thinsp;0.757, respectively, P\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The MCS dimension of the quality of life score was positively correlated with the BI score, with a correlation coefficient of r\u0026thinsp;=\u0026thinsp;0.589 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and negatively correlated with the PTSD-SS and NHP-part II scores, with correlation coefficients of r= -0.741 and \u0026minus;\u0026thinsp;0.647 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.01), respectively (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCorrelation analysis of PCSand MCS dimension and scores of each scale\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePCS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMCS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePTSD-SS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNHP-part II\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.764**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.560**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.589**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTSD-SS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.580**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.741**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.519**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNHP-part II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.757**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.647**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.307**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.492**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e注: **\u003cem\u003eP\u003c/em\u003e\u0026lt;0.01。\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e3.5.2 Analysis of multiple factors affecting long-term quality of life of severe patients treated with ECMO\u003c/h2\u003e \u003cp\u003eIn this study, statistically significant variables in the non-parametric test and correlation analysis were included in the multi-factor regression analysis. Independent variables were assigned values, and a multiple linear regression analysis was performed. First, the Tolerance and Variance inflation factor was used to test for multicollinearity in the regression equation. In the diagnosis of the model, the mean residual (1.17) was close to 0, the standard deviation (0.931) was close to 1, and the data were normally distributed. The scatter plot of the residual plot indicated that the data met the conditions of variance, homogeneity, and independence (\u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;22.283, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating that the model was statistically significant.\u003c/p\u003e \u003cp\u003eThe results showed that in the PCS dimension, caregiver type, on-the-job status, BI level, PTSD-SS level, and NHP-part II level were independent influencing factors (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and the adjusted R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.826 was high with a good fit. In the MCS dimension, employment status, place of residence, BI level, PTSD-SS level, and NHP-part II level were independent influencing factors (\u003cspan type=\"ItalicUnderline\" class=\"ItalicUnderline\" name=\"Emphasis\"\u003eP\u003c/span\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and the adjusted R2\u0026thinsp;=\u0026thinsp;0.774 was at a high level with a good fit, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eResults of multiple linear regression analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfluencing factor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eSE\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTolerance\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003eVIF\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59.913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.931\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver type=\u003c/p\u003e \u003cp\u003eChildren or carers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-4.878\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.294\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver type=\u003c/p\u003e \u003cp\u003ecompanion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-8.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-3.468\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.563\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.778\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn-the-job status\u0026thinsp;=\u0026thinsp;dimission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-18.821\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.088\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.057\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.043\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.092\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn-the-job status\u0026thinsp;=\u0026thinsp;retire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-10.776\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-3.258\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.445\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.248\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn-the-job status\u0026thinsp;=\u0026thinsp;unemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-10.979\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-4.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.418\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.391\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.672\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.645\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTSD-SS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.173\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.999\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNHP-part II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-2.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-7.171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.537\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.862\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.799\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.688\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn-the-job status\u0026thinsp;=\u0026thinsp;retire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-8.762\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.574\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.741\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn-the-job status\u0026thinsp;=\u0026thinsp;unemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-6.911\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.541\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.951\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.447\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.236\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOn-the-job status\u0026thinsp;=\u0026thinsp;dimission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.292\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.974\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.876\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.142\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of Residence\u0026thinsp;=\u0026thinsp;village\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.437\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.532\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.256\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.631\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlace of Residence\u0026thinsp;=\u0026thinsp;city\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.685\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.726\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.505\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.236\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.752\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.627\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.594\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePTSD-SS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.673\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.417\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-6.115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.534\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.874\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNHP-part II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.701\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.547\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-3.108\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003ePCS: \u003cem\u003eR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.852, \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.826, \u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;32.104, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001;\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eMCS: \u003cem\u003eR\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.774, \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.739, \u003cem\u003eF\u003c/em\u003e\u0026thinsp;=\u0026thinsp;22.283, \u003cem\u003eP\u003c/em\u003e\u0026lt;0.001。\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe long-term quality of life of adult ECMO survivors must be improved. In this study, the long-term quality of life of adult ECMO survivors was lower with regards to the PCS dimension (65.35\u0026thinsp;\u0026plusmn;\u0026thinsp;27.47 vs 63.72\u0026thinsp;\u0026plusmn;\u0026thinsp;20.87) and higher in the MCS dimension (69.45\u0026thinsp;\u0026plusmn;\u0026thinsp;27.87 vs 72.69\u0026thinsp;\u0026plusmn;\u0026thinsp;23.67) than that of foreign ECMO-treated patients. This may be related to the patients\u0026rsquo; follow-up time, sample size, demographic characteristics, and disease types. Compared with patients undergoing maintenance hemodialysis, patients treated with ECMO had a higher quality of life, and the scores of the PCS (56.84\u0026thinsp;\u0026plusmn;\u0026thinsp;19.43 vs 63.72\u0026thinsp;\u0026plusmn;\u0026thinsp;20.87) and MCS dimensions (50.63\u0026thinsp;\u0026plusmn;\u0026thinsp;18.92 vs 72.69\u0026thinsp;\u0026plusmn;\u0026thinsp;23.67) were both higher than those of the patients undergoing hemodialysis. This was consistent with the results reported by Spangenberg et al. \u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e. This may be because patients undergoing maintenance hemodialysis need frequent hospital visits for treatment, whereas some patients treated with ECMO only need regular hospital visits after resolving the primary disease, and the burden of disease treatment is relatively low.\u003c/p\u003e \u003cp\u003eIn terms of self-care ability, 72.65% of patients did not need to rely on family members, which needs to be further improved compared with the 84.4% of patients who can take care of themselves completely, as reported by Benjamin \u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e. Self-care ability depends on the presence of complications affecting daily life after discharge. In this study, the incidence of complications after catheterization was 18.9%, which included mainly lower limb ischemia, thromboembolism, nervous system injury, and chronic renal failure. Of these, bleeding and thromboembolism can be effectively controlled or solved during hospitalization; however, lower limb ischemia, nervous system injury, and chronic renal failure can persist in patients after discharge and even require lifelong treatment, which directly or indirectly affects the long-term quality of life of patients. In a meta-analysis \u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e, the combined prevalence of late vascular complications of ECMO was found to be 8.1%. In our study, the combined prevalence of late vascular complications of ECMO was 4.72%. The decrease in vascular complications may be related to the active establishment of collateral circulation at our center for lower limb reperfusion to reduce or avoid the occurrence of lower limb ischemia.\u003c/p\u003e \u003cp\u003eIn terms of post-traumatic stress disorder, the incidence of high-level post-traumatic stress disorder in this study was 17.0%, which is lower than the 30.8% reported by Harley et al. \u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e. This could be because the patients who were followed up in this study had been discharged from the hospital for more than three months, and their memory of ECMO events had decreased or blurred. With the companionship of family and gradual recovery from the disease, their psychological state tended to be stable.\u003c/p\u003e \u003cp\u003eIn terms of social function, 56.6% of the patients in this study had impaired social function, and only 37.7% of the patients were working, whereas in the study by Rilinger \u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e, patients with VV-ECMO reached an 80% in-service rate. Patients in our center had a relatively low in-service rate because they were mixed with patients on VA-ECMO. Conversely, our incumbency rate excluded nearly 20% of retirees. In our study, 38% and 37.5% of patients treated with the V-V and V-A modes were on duty, respectively. This result is consistent with those of previous studies \u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn the multifactor analysis affecting the long-term quality of life of severely ill patients treated with ECMO, the type of caregiver was an independent factor influencing the PCS dimension. When the caregiver was the spouse, the patient's quality of life score was lower, which may be related to the fact that the patient's physical function had not recovered, the patient needed extra help, and the spouse was the closest family member. Moreover, under greater care pressure, when patients feel dual physical and psychological pressure, they will experience more negative emotions. In-service status after discharge was an independent factor affecting the two dimensions of quality of life. The quality of life of patients with an on-the-job status is significantly higher than that of patients who leave their jobs, retire, or lose their jobs. When patients recover physically and participate in social work, their physical and psychological recovery can be promoted. The degree of participation in social activities had a significant positive correlation with quality of life, which is consistent with the results of Hsieh et al. \u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003e. In addition, the quality of life of patients living in cities is higher, which may be related to better medical conditions, a more convenient life, and a better material basis. BI, PTSD-SS, and NHP-part II scores of patients were significantly correlated with quality of life and better self-care ability; lower post-traumatic stress disorder and lower impaired social function could predict a better quality of life.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Limitations and prospects\u003c/h2\u003e \u003cp\u003eThis study has some limitations. This was a single-center study, and there may be some limitations in the selection of samples. This study only investigated the long-term quality of life of some patients in a single center, and the results were regional. In the future, a multicenter national survey should be conducted to better understand the long-term quality of life of severely ill patients treated with ECMO in China. This study was designed to investigate patients who have been discharged from the hospital for more than three months, and there is a lack of data on the prospective investigation of patients within three months of discharge; therefore, a prospective scientific study should be carried out at a later stage to supplement the lack of current data on patients' quality of life within three months of discharge.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn general, the long-term quality of life of adult ECMO survivors is poor, and there are different degrees of physiological, psychological, and social dysfunctions, especially regarding the urgent need to restore social function. Long-term quality of life is affected by a variety of factors. It may be necessary for professional medical teams to conduct long-term management of chronic diseases by setting up ECMO professional outpatient clinics, online follow-up, offline family follow-up, and other methods to provide more comprehensive and accurate care, improve the long-term quality of life as a whole, and extend the survival period of survivors.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBI\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Barthel Index (BI)\u003c/p\u003e\n\u003cp\u003eBP\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Body pain\u003c/p\u003e\n\u003cp\u003eECPR\u0026nbsp;\u0026nbsp;Extracorporeal cardiopulmonary resuscitation (ECPR)\u003c/p\u003e\n\u003cp\u003eECMO\u0026nbsp;Extracorporeal membrane oxygenation\u003c/p\u003e\n\u003cp\u003eELSO\u0026nbsp;\u0026nbsp;Extracorporeal Life Support Organization (ELSO)\u003c/p\u003e\n\u003cp\u003eGUH\u0026nbsp; \u0026nbsp;General health\u003c/p\u003e\n\u003cp\u003eHRQOL Health-related quality of life\u003c/p\u003e\n\u003cp\u003eICU \u0026nbsp; \u0026nbsp;\u0026nbsp;Intensive care unit\u003c/p\u003e\n\u003cp\u003eMCS\u0026nbsp; \u0026nbsp;\u0026nbsp;Mental health content\u003c/p\u003e\n\u003cp\u003eNHP part II Nottingham Health Profile part II .\u003c/p\u003e\n\u003cp\u003eSF-36, 36-item short form health survey (SF-36)\u003c/p\u003e\n\u003cp\u003ePCS \u0026nbsp; \u0026nbsp;\u0026nbsp;Physical health content\u003c/p\u003e\n\u003cp\u003ePF- \u0026nbsp; \u0026nbsp; \u0026nbsp;Physical functioning\u003c/p\u003e\n\u003cp\u003ePTSD\u0026nbsp;\u0026nbsp;Post-traumatic self-stress disorder rating scale (PTSD-SS),\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRE\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Role emotion\u003c/p\u003e\n\u003cp\u003eVT\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Vitality\u003c/p\u003e\n\u003cp\u003eV-V ECMO Veno-venous\u0026nbsp;Extracorporeal membrane oxygenation\u003c/p\u003e\n\u003cp\u003eV-A ECMO \u0026nbsp; \u0026nbsp;Veno-arterial Extracorporeal membrane oxygenation\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study followed the principles of the Declaration of Helsinki and was approved by the Ethics Committee of Sichuan Provincial People\u0026apos;s Hospital (approval number: 2022-91). All the participants provided informed consent. In compliance with confidentiality, the details of the participants were not provided.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the patient for publication of this case report and any accompanying images.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset used and/or analyzed during the current study is available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe declare that we have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions\u003c/p\u003e\n\u003cp\u003eF.Y.,X.Z.,C.P.,R.L.and X.H.\u0026nbsp;conceived the study and took responsibility for the integrity of the study.\u0026nbsp;X.L.\u0026nbsp;and J.L. joined in study design, data analysis, data interpretation, and manuscript preparation.\u0026nbsp;Y.L,\u0026nbsp;F.Z,\u0026nbsp;Y.L.joined in patient screening, data collection, data management, data interpretation, and revised the manuscript. All authors contributed to the intellectual content of the manuscript and approved the final version submitted for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThanks to all the interviewees for their active cooperation.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFicial B, Vasques F, Zhang J, Whebell S, Slattery M, Lamas T, et al. Physiological basis of extracorporeal membrane oxygenation and extracorporeal carbon dioxide removal in respiratory failure. Membranes (Basel)\u003cem\u003e. \u003c/em\u003e2021;11. https://doi.org/10.3390/membranes11030225\u003c/li\u003e\n\u003cli\u003eExtracorporeal Life Support Organization | ELSO | ECMO[EB/OL].2022-12-12,https://www.elso.org/. \u003c/li\u003e\n\u003cli\u003eThiagarajan RR, Barbaro RP, Rycus PT, McMullan DM, Conrad SA, Fortenberry JD, et al. Extracorporeal life support organization registry international report 2016. ASAIO J\u003cem\u003e. \u003c/em\u003e2017;63:60\u0026ndash;7. https://doi.org/10.1097/MAT.0000000000000475\u003c/li\u003e\n\u003cli\u003eEnger TB, Philipp A, Lubnow M, Fischer M, Camboni D, Lunz D, et al. Long-term survival in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation. Crit Care Med\u003cem\u003e. \u003c/em\u003e2017;45:1718\u0026ndash;25. https://doi.org/10.1097/CCM.0000000000002644\u003c/li\u003e\n\u003cli\u003evon Bahr V, Hultman J, Eksborg S, Frenckner B, Kalz\u0026eacute;n H. Long-term survival in adults treated with extracorporeal membrane oxygenation for respiratory failure and sepsis. Crit Care Med\u003cem\u003e. \u003c/em\u003e2017;45:164\u0026ndash;70. https://doi.org/10.1097/CCM.0000000000002078\u003c/li\u003e\n\u003cli\u003eTiedebohl JM, DeFabio ME, Bell T, Buchko BL, Woods AB. ECMO survivors\u0026rsquo; quality of life and needs after discharge: A descriptive, comparative cross-sectional pilot study. Intensive Crit Care Nurs\u003cem\u003e. \u003c/em\u003e2020;59:102829. https://doi.org/10.1016/j.iccn.2020.102829\u003c/li\u003e\n\u003cli\u003eSanfilippo F, Ippolito M, Santonocito C, Martucci G, Carollo T, Bertani A\u003cem\u003e, \u003c/em\u003eet al. Long-term functional and psychological recovery in a population of acute respiratory distress syndrome patients treated with VV-ECMO and in their caregivers. Minerva Anestesiol\u003cem\u003e. \u003c/em\u003e2019;85:971\u0026ndash;80. https://doi.org/10.23736/S0375-9393.19.13095-7\u003c/li\u003e\n\u003cli\u003eGalazzi A, Brambilla A, Grasselli G, Pesenti A, Fumagalli R, Lucchini A. Quality of life of adult survivors after extra corporeal membrane oxygenation (ECMO): A quantitative study. Dimens Crit Care Nurs\u003cem\u003e. \u003c/em\u003e2018;37:12\u0026ndash;7. https://doi.org/10.1097/DCC.0000000000000278\u003c/li\u003e\n\u003cli\u003eNorkiene I, Jovaisa T, Scupakova N, Janusauskas V, Rucinskas K, Serpytis P, et al. Long-term quality of life in patients treated with extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock. Perfusion\u003cem\u003e. \u003c/em\u003e2019;34:285\u0026ndash;9. https://doi.org/10.1177/0267659118815291\u003c/li\u003e\n\u003cli\u003e\u0026Oslash;rbo MC, Karlsen SF, Pedersen EP, Hermansen SE, R\u0026oslash;nning PB, Nergaard KA, et al. Health-related quality of life after extracorporeal membrane oxygenation: A single centre\u0026rsquo;s experience. ESC Heart Fail\u003cem\u003e. \u003c/em\u003e2019;6:701\u0026ndash;10. https://doi.org/10.1002/ehf2.12433\u003c/li\u003e\n\u003cli\u003eWilcox ME, Jaramillo-Rocha V, Hodgson C, Taglione MS, Ferguson ND, Fan E. Long-term quality of life after extracorporeal membrane oxygenation in ARDS survivors: Systematic review and meta-analysis. J Intensive Care Med\u003cem\u003e. \u003c/em\u003e2020;35:233\u0026ndash;43. https://doi.org/10.1177/0885066617737035\u003c/li\u003e\n\u003cli\u003eRoll MA, Kuys S, Walsh JR, Tronstad O, Ziegenfuss MD, Mullany DV. Long-term survival and health-related quality of life in adults after extra corporeal membrane oxygenation. Heart Lung Circ\u003cem\u003e. \u003c/em\u003e2019;28:1090\u0026ndash;8. https://doi.org/10.1016/j.hlc.2018.06.1044\u003c/li\u003e\n\u003cli\u003eRui W, Cheng W, Ma XQ, Zhao YF, Yan XY, Jia H. Health-related quality of life in Chinese people: A population-based survey of five cities in China. Scand J Public Health\u003cem\u003e. \u003c/em\u003e2011;39:410\u0026ndash;8. https://doi.org/10.1177/1403494810395817\u003c/li\u003e\n\u003cli\u003eSpangenberg T, Schewel J, Dreher A, Meincke F, Bahlmann E, van der Schalk H\u003cem\u003e, \u003c/em\u003eet al. Health related quality of life after extracorporeal cardiopulmonary resuscitation in refractory cardiac arrest. Resuscitation\u003cem\u003e. \u003c/em\u003e2018;127:73\u0026ndash;8. https://doi.org/10.1016/j.resuscitation.2018.03.036\u003c/li\u003e\n\u003cli\u003eImmohr MB, Eschlb\u0026ouml;ck SM, Rellecke P, Dalyanoglu H, Tudorache I, Boeken U, et al. The quality of afterlife: Surviving extracorporeal life support after therapy-refractory circulatory failure-a comprehensive follow-up analysis. ESC Heart Fail. 2021;8:4968\u0026ndash;75. https://doi.org/10.1002/ehf2.13554\u003c/li\u003e\n\u003cli\u003eJia D, Yang IX, Ling RR, Syn N, Poon WH, Murughan K, et al. Vascular complications of extracorporeal membrane oxygenation: A systematic review and meta-regression analysis. Crit Care Med\u003cem\u003e. \u003c/em\u003e2020;48:e1269\u0026ndash;77-e1277. https://doi.org/10.1097/CCM.0000000000004688\u003c/li\u003e\n\u003cli\u003eHarley O, Reynolds C, Nair P, Buscher H. Long-Term Survival, Posttraumatic Stress, and Quality of Life post Extracorporeal Membrane Oxygenation. ASAIO J\u003cem\u003e. \u003c/em\u003e2020;66:909\u0026ndash;14. https://doi.org/10.1097/MAT.0000000000001095\u003c/li\u003e\n\u003cli\u003eRilinger J, Kr\u0026ouml;tzsch K, Bemtgen X, J\u0026auml;ckel M, Zotzmann V, Lang CN\u003cem\u003e, \u003c/em\u003eet al. Long-term survival and health-related quality of life in patients with severe acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation support. Crit Care\u003cem\u003e. \u003c/em\u003e2021;25:410. https://doi.org/10.1186/s13054-021-03821-0\u003c/li\u003e\n\u003cli\u003eStadlbauer A, Philipp A, Blecha S, Lubnow M, Lunz D, Li J, et al. Long-term follow-up and quality of life in patients receiving extracorporeal membrane oxygenation for pulmonary embolism and cardiogenic shock. Ann Intensive Care\u003cem\u003e. \u003c/em\u003e2021;11:181. https://doi.org/10.1186/s13613-021-00975-6\u003c/li\u003e\n\u003cli\u003eChommeloux J, Valentin S, Winiszewski H, Adda M, Pineton de Chambrun M, Moyon Q\u003cem\u003e, \u003c/em\u003eet al. One-year mental and physical health assessment in survivors after extracorporeal membrane oxygenation for COVID-19-related acute respiratory distress syndrome. Am J Respir Crit Care Med\u003cem\u003e. \u003c/em\u003e2023;207:150\u0026ndash;9. https://doi.org/10.1164/rccm.202206-1145OC\u003c/li\u003e\n\u003cli\u003eHsieh FT, Huang GS, Ko WJ, Lou MF. Health status and quality of life of survivors of extra corporeal membrane oxygenation: A cross-sectional study. J Adv Nurs\u003cem\u003e. \u003c/em\u003e2016;72:1626\u0026ndash;37. https://doi.org/10.1111/jan.12943\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"extracorporeal membrane oxygenation, critically ill patients, long-term quality of life, influencing factors","lastPublishedDoi":"10.21203/rs.3.rs-3990827/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3990827/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e To understand the present situation of long-term quality of life of adult extracorporeal membrane oxygenation (ECMO) survivors, this study aimed to analyze and discuss the influencing factors and provide a reference for standardizing continuous nursing schemes for such patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA cross-sectional survey was conducted by objective sampling using the General Information Questionnaire, 36-item short form health survey (SF-36), Barthel Index (BI), post-traumatic self-stress disorder rating scale (PTSD-SS), and Nottingham Health Profile part II (NHP-part II). A total of 106 adult ECMO survivors were included in the study. The quality of life, self-care ability, psychological state, and social adaptability of the patients were evaluated using investigative tools.\u003c/p\u003e\n\u003cp\u003eA two-sample rank sum test or multi-sample Kruskal–Wallis test, Spearman correlation analysis, and multiple linear regression were used for statistical analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study’s results showed that the score of long-term quality of life in adult ECMO survivors was (63.72±20.87) and that of their mental health was (72.69±23.67). Physical health was positively correlated with the BI score (r=0.560, P \u0026lt; 0.01) and negatively correlated with the PTSD-SS (r=-0.58, P \u0026lt; 0.01) and NHP-part II score (r=-0.757, P \u0026lt; 0.01). Mental health was positively correlated with the BI score (r=0.589, P \u0026lt; 0.01) and negatively correlated with the post-traumatic stress disorder self-rating score (r=-0.741, P \u0026lt; 0.01) and NHP-part II score (r=-0.647, P \u0026lt; 0.01). Physical health content, caregiver type, on-the-job status, BI evaluation score, PTSD-SS, and NHP-part II score were independent influencing factors of quality of life (P \u0026lt; 0.05), which explained 82.6 % of the variability. The content dimensions of mental health, working status, residence, BI evaluation score, PTSD-SS, and the NHP-part-II score were independent influencing factors (P \u0026lt; 0.05), which explained 73.9 % of the variation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSurviving adult patients on ECMO have poor long-term quality of life and varying degrees of physical, psychological, and social dysfunction, with especially social functions that are in urgent need of restoration. Long-term quality of life is affected by many factors, including caregiver type, employment status, BI level, PTSD-SS level, NHP-part II level, and place of residence. A professional medical team is needed to establish ECMO professional clinics to provide more comprehensive and accurate care and improve the overall quality of life.\u003c/p\u003e","manuscriptTitle":"Long-term quality of life in adult extracorporeal membrane oxygenation survivors: A single-center, cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-12 17:23:15","doi":"10.21203/rs.3.rs-3990827/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-09-11T08:12:46+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-11T07:55:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"173990840728851943511858725856786769247","date":"2024-09-11T07:38:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"53978485227948570284954558748179517458","date":"2024-09-09T00:01:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"108814760535909662307165033796882425102","date":"2024-09-08T15:07:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282108651582337170932955246152708946300","date":"2024-09-08T15:00:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"182227471286912764492568989047818408294","date":"2024-09-06T22:21:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"144970868747374717678772473580052554187","date":"2024-09-06T08:06:22+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"181463434581209334548605464609556788875","date":"2024-09-06T06:32:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-21T09:46:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"27769244196801899287486612998355474232","date":"2024-08-12T09:38:26+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-29T14:43:27+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-04-10T10:20:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-03-09T09:22:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-03-08T08:51:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2024-02-26T11:44:57+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f82ba3af-ff82-421d-9fb0-a80500fd1501","owner":[],"postedDate":"March 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-11-25T16:08:20+00:00","versionOfRecord":{"articleIdentity":"rs-3990827","link":"https://doi.org/10.1186/s12889-024-20782-5","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2024-11-21 15:58:07","publishedOnDateReadable":"November 21st, 2024"},"versionCreatedAt":"2024-03-12 17:23:15","video":"","vorDoi":"10.1186/s12889-024-20782-5","vorDoiUrl":"https://doi.org/10.1186/s12889-024-20782-5","workflowStages":[]},"version":"v1","identity":"rs-3990827","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3990827","identity":"rs-3990827","version":["v1"]},"buildId":"WrCJVZZCHTDjtuVLN7oU0","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}