Abstract:Objective To investigate the value of the fibrinogen-to-albumin ratio (FAR) combined with platelet count in predicting thromboembolic complications during venous-arterial extracorporeal membrane oxygenation(VA-ECMO). Methods Clinical data from 130 patients who received VA-ECMO therapy in the Intensive Care Unit of The Second Affiliated Hospital of Zhengzhou University from 2020 to 2023 were retrospectively collected. Logistic regression analysis was used to identify risk factors for thromboembolic complications. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to evaluate the predictive ability of FAR combined with platelet count for thromboembolic complications. Results A total of 130 patients were included, of which 87 were male and 43 were female, with an age of (52.2±15.3) years. All patients received VA-ECMO treatment. Thirty-three patients developed thromboembolic complications. Compared to patients without thromboembolic complications, those who developed complications had higher fibrinogen and FAR levels on Day 1 of VA-ECMO (P＜0.05) and lower platelet count and albumin levels after VA-ECMO initiation, and on Days 1 and 3 (P＜0.05). According to multivariate logistic regression, FAR on Day 1 was independently associated with thromboembolic complications (P＜0.05), with an AUC of 0.690 (95%CI:0.569-0.810).Platelet count on Day 1 was also independently associated with thromboembolic complications (P＜0.05), with an AUC of 0.664 (95%CI:0.558-0.771). The combined prediction of thromboembolic complications using both FAR and platelet count resulted in the highest predictive value, with an AUC of 0.794 (95%CI:0.703-0.885).Conclusion The combination of FAR and platelet count on Day 1 of VA-ECMO can be used to predict the occurrence of thromboembolic complications during VA-ECMO support.