{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:20:48Z","timestamp":1790428848424,"version":"4.1.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum D\u00fcsseldorf. Anstalt \u00f6ffentlichen Rechts"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) supports patients suffering from refractory cardiogenic shock. Thromboembolic complications (TeC) are common in VA-ECMO patients and are associated with increased morbidity and mortality. Valid markers to predict TeC in VA-ECMO patients are lacking. The present study investigated the predictive value of baseline Fibrinogen\u2013Albumin-Ratio (FAR) for in-hospital TeC in patients undergoing VA-ECMO. This retrospective cohort study included patients who underwent VA-ECMO therapy due to cardiogenic shock at the University Hospital Duesseldorf, Germany between 2011 and 2018. Main exposure was baseline FAR measured at initiation of VA-ECMO therapy. The primary endpoint was the in-hospital incidence of TeC. In total, 344 patients were included into analysis (74.7% male, mean age 59\u2009\u00b1\u200914\u00a0years). The in-hospital incidence of TeC was 34%. Receiver operating characteristics (ROC) curve of FAR for in-hospital TeC revealed an area under the curve of 0.67 [95% confidence interval (CI) 0.61\u20130.74]. Youden index determined a cutoff of 130 for baseline FAR. Multivariate logistic regression revealed an adjusted odds-ratio of 3.72 [95% CI 2.26\u20136.14] for the association between FAR and TeC. Baseline FAR is independently associated with in-hospital TeC in patients undergoing VA-ECMO. Thus, FAR might contribute to the prediction of TeC in this cohort.<\/jats:p>","DOI":"10.1038\/s41598-021-95689-x","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T10:05:02Z","timestamp":1629194702000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Fibrinogen\u2013Albumin-Ratio is an independent predictor of thromboembolic complications in patients undergoing VA-ECMO"],"prefix":"10.1038","volume":"11","author":[{"given":"Sebastian","family":"Roth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catrin","family":"Jansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"M\u2019Pembele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Stroda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Boeken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payam","family":"Akhyari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artur","family":"Lichtenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus W.","family":"Hollmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ragnar","family":"Huhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Lurati Buse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hug","family":"Aubin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"95689_CR1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1007\/s00063-020-00755-3","volume":"116","author":"U Boeken","year":"2021","unstructured":"Boeken, U. et al. Extracorporeal life support (ECLS)\u2014Update 2020. Medizinische Klin. - Intensivmed. und Notfallmedizin 116, 56\u201358 (2021).","journal-title":"Medizinische Klin. - Intensivmed. und Notfallmedizin"},{"key":"95689_CR2","doi-asserted-by":"crossref","unstructured":"Kowalewski, M. et al. Venoarterial extracorporeal membrane oxygenation for postcardiotomy shock\u2014Analysis of the extracorporeal life support organization registry. Crit. Care Med. (Publish Ah) (2021).","DOI":"10.1097\/CCM.0000000000004922"},{"key":"95689_CR3","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","volume":"37","author":"P Ponikowski","year":"2016","unstructured":"Ponikowski, P. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J. 37, 2129\u20132200m (2016).","journal-title":"Eur. Heart J."},{"key":"95689_CR4","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/j.jchf.2016.03.018","volume":"4","author":"H Aubin","year":"2016","unstructured":"Aubin, H. et al. A suprainstitutional network for remote extracorporeal life support: A retrospective cohort study. JACC Hear. Fail. 4, 698\u2013708 (2016).","journal-title":"JACC Hear. Fail."},{"key":"95689_CR5","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3400472","author":"A Mehdiani","year":"2020","unstructured":"Mehdiani, A. et al. Extracorporeal membrane oxygenation after heart transplantation: Impact of type of cannulation. Thorac. Cardiovasc. Surg. https:\/\/doi.org\/10.1055\/s-0039-3400472 (2020).","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"95689_CR6","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.3390\/jcm9061727","volume":"9","author":"S Bunte","year":"2020","unstructured":"Bunte, S. et al. Bilirubin\u2014A possible prognostic mortality marker for patients with ECLS. J. Clin. Med. 9, 1727 (2020).","journal-title":"J. Clin. Med."},{"key":"95689_CR7","doi-asserted-by":"publisher","first-page":"e004905","DOI":"10.1161\/CIRCHEARTFAILURE.118.004905","volume":"11","author":"P Rao","year":"2018","unstructured":"Rao, P., Khalpey, Z., Smith, R., Burkhoff, D. & Kociol, R. D. Venoarterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest. Circ. Heart Fail. 11, e004905 (2018).","journal-title":"Circ. Heart Fail."},{"key":"95689_CR8","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1016\/j.jacc.2014.07.958","volume":"64","author":"R Stretch","year":"2014","unstructured":"Stretch, R., Sauer, C. M., Yuh, D. D. & Bonde, P. National trends in the utilization of short-term mechanical circulatory support: Incidence, outcomes, and cost analysis. J. Am. Coll. Cardiol. 64, 1407\u20131415 (2014).","journal-title":"J. Am. Coll. Cardiol."},{"key":"95689_CR9","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.1016\/j.jtcvs.2018.05.061","volume":"156","author":"T Fux","year":"2018","unstructured":"Fux, T., Holm, M., Corbascio, M., Lund, L. H. & van der Linden, J. Venoarterial extracorporeal membrane oxygenation for postcardiotomy shock: Risk factors for mortality. J. Thorac. Cardiovasc. Surg. 156, 1894-1902.e3 (2018).","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"95689_CR10","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1213\/ANE.0000000000004711","volume":"131","author":"SG De Hert","year":"2020","unstructured":"De Hert, S. G. & Lurati Buse, G. A. Cardiac biomarkers for the prediction and detection of adverse cardiac events after noncardiac surgery: A narrative review. Anesth. Analg. 131, 187\u2013195 (2020).","journal-title":"Anesth. Analg."},{"key":"95689_CR11","doi-asserted-by":"crossref","unstructured":"Zhang, D. P. et al. The Fibrinogen-to-Albumin Ratio is associated with outcomes in patients with coronary artery disease who underwent percutaneous coronary intervention. Clin. Appl. Thromb. 26, (2020).","DOI":"10.1177\/1076029620933008"},{"key":"95689_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12885-019-6169-0","volume":"20","author":"Q An","year":"2020","unstructured":"An, Q., Liu, W., Yang, Y. & Yang, B. Preoperative fibrinogen-to-albumin ratio, a potential prognostic factor for patients with stage IB-IIA cervical cancer. BMC Cancer 20, 1\u20138 (2020).","journal-title":"BMC Cancer"},{"key":"95689_CR13","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1080\/09537104.2020.1760230","volume":"31","author":"X Bi","year":"2020","unstructured":"Bi, X. et al. Prediction of severe illness due to COVID-19 based on an analysis of initial Fibrinogen to Albumin Ratio and Platelet count. Platelets 31, 674\u2013679 (2020).","journal-title":"Platelets"},{"key":"95689_CR14","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/S1357-2725(99)00032-1","volume":"31","author":"S Herrick","year":"1999","unstructured":"Herrick, S., Blanc-Brude, O., Grey, A. & Laurent, G. Fibrinogen. Int. J. Biochem. Cell Biol. 31, 741\u2013746 (1999).","journal-title":"Int. J. Biochem. Cell Biol."},{"key":"95689_CR15","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1002\/jbm.820240203","volume":"24","author":"JN Mulvihill","year":"1990","unstructured":"Mulvihill, J. N., Faradji, A., Oberling, F. & Cazenave, J.-P. Surface passivation by human albumin of plasmaperesis circuits reduces platelet accumulation and thrombus formation. Experimental and clinical studies. J. Biomed. Mater. Res. 24, 155\u2013163 (1990).","journal-title":"J. Biomed. Mater. Res."},{"key":"95689_CR16","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.athoracsur.2016.10.051","volume":"104","author":"M Thielmann","year":"2017","unstructured":"Thielmann, M. et al. Heart-type fatty acid binding protein and ischemia-modified albumin for detection of myocardial infarction after coronary artery bypass graft surgery. Ann. Thorac. Surg. 104, 130\u2013137 (2017).","journal-title":"Ann. Thorac. Surg."},{"key":"95689_CR17","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000992","author":"P Acharya","year":"2020","unstructured":"Acharya, P. et al. Fibrinogen albumin ratio and ischemic stroke during venoarterial extracorporeal membrane oxygenation. ASAIO J. https:\/\/doi.org\/10.1097\/MAT.0000000000000992 (2020).","journal-title":"ASAIO J."},{"key":"95689_CR18","doi-asserted-by":"publisher","first-page":"2325","DOI":"10.1016\/S0140-6736(18)30832-8","volume":"391","author":"PJ Devereaux","year":"2018","unstructured":"Devereaux, P. J. et al. Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): An international, randomised, placebo-controlled trial. Lancet 391, 2325\u20132334 (2018).","journal-title":"Lancet"},{"key":"95689_CR19","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1093\/eurheartj\/ehy462","volume":"40","author":"K Thygesen","year":"2019","unstructured":"Thygesen, K. et al. Fourth universal definition of myocardial infarction (2018). Eur. Heart J. 40, 237\u2013269 (2019).","journal-title":"Eur. Heart J."},{"key":"95689_CR20","doi-asserted-by":"publisher","DOI":"10.1161\/str.0000000000000375","author":"DO Kleindorfer","year":"2021","unstructured":"Kleindorfer, D. O. et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association\/American Stroke Association. Stroke https:\/\/doi.org\/10.1161\/str.0000000000000375 (2021).","journal-title":"Stroke"},{"key":"95689_CR21","doi-asserted-by":"publisher","first-page":"2246","DOI":"10.1093\/eurheartj\/ehv194","volume":"36","author":"M Schmidt","year":"2015","unstructured":"Schmidt, M. et al. Predicting survival after ECMO for refractory cardiogenic shock: The survival after veno-arterial-ECMO (SAVE)-score. Eur. Heart J. 36, 2246\u20132256 (2015).","journal-title":"Eur. Heart J."},{"key":"95689_CR22","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s13613-016-0172-2","volume":"6","author":"FC Trudzinski","year":"2016","unstructured":"Trudzinski, F. C. et al. Runtime and aPTT predict venous thrombosis and thromboembolism in patients on extracorporeal membrane oxygenation: A retrospective analysis. Ann. Intensive Care 6, 2\u20139 (2016).","journal-title":"Ann. Intensive Care"},{"key":"95689_CR23","doi-asserted-by":"publisher","first-page":"E136","DOI":"10.1111\/aor.12793","volume":"40","author":"A Loforte","year":"2016","unstructured":"Loforte, A. et al. Role of intra-aortic balloon pump and extracorporeal membrane oxygenation in early graft failure after cardiac transplantation. Artif. Organs 40, E136\u2013E145 (2016).","journal-title":"Artif. Organs"},{"key":"95689_CR24","doi-asserted-by":"publisher","first-page":"1920","DOI":"10.1097\/CCM.0000000000004635","volume":"48","author":"RI Parker","year":"2020","unstructured":"Parker, R. I. Anticoagulation monitoring during extracorporeal membrane oxygenation: Continuing progress. Crit. Care Med. 48, 1920\u20131921 (2020).","journal-title":"Crit. Care Med."},{"key":"95689_CR25","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1177\/0885066618776937","volume":"35","author":"C Delmas","year":"2020","unstructured":"Delmas, C. et al. Anticoagulation monitoring under ECMO support: A comparative study between the activated coagulation time and the anti-Xa activity assay. J. Intensive Care Med. 35, 679\u2013686 (2020).","journal-title":"J. Intensive Care Med."},{"key":"95689_CR26","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1053\/j.jvca.2012.07.019","volume":"1","author":"M Pieri","year":"2013","unstructured":"Pieri, M. et al. Bivalirudin versus heparin as an anticoagulant during extracorporeal membrane oxygenation: A case\u2013control study. J. Cardiothorac. Vasc. Anesth. 1, 30\u201334 (2013).","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"95689_CR27","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13054-021-03581-x","volume":"1","author":"C Fisser","year":"2021","unstructured":"Fisser, C. et al. Argatroban versus heparin in patients without heparin-induced thrombocytopenia during venovenous extracorporeal membrane oxygenation: A propensity-score matched study. Crit. Care 1, 10. https:\/\/doi.org\/10.1186\/s13054-021-03581-x (2021).","journal-title":"Crit. Care"},{"key":"95689_CR28","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1097\/ALN.0000000000002701","volume":"131","author":"A Jerath","year":"2019","unstructured":"Jerath, A., Austin, P. C. & Wijeysundera, D. N. Days alive and out of hospital: Validation of a patient-centered outcome for perioperative medicine. Anesthesiology 131, 84\u201393 (2019).","journal-title":"Anesthesiology"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95689-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95689-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95689-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T12:50:06Z","timestamp":1670071806000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-95689-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,17]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["95689"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-95689-x","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,17]]},"assertion":[{"value":"10 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16648"}}