Dilek Dilli1, Hasan Akduman2, Utku Arman Orun3, Mehmet Tasar4, Irfan Tasoglu5, Seda Aydogan2, Rumeysa Citli2, Sercan Tak4. 1. Department of Neonatology, Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey. Correspondence to: Dr Dilek Dilli, Sami Ulus Maternity and Children Research and Training Hospital, Ankara/Turkey. dilekdilli2@yahoo.com. 2. Department of Neonatology, Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey. 3. Department of Pediatric Cardiology, Sami Ulus Maternity and Children Research and Training Hospital, Ankara,Turkey. 4. Department of Pediatric Cardiovascular Surgery, Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey. 5. Turkiye Yuksek Ihtisas Training and Research Hospital, University of Health Sciences; Ankara, Turkey.
Abstract
OBJECTIVE: Vasoactive-inotropic Score (VIS) was developed to quantify the amount of inotropic support provided in the postoperative period. We investigated the predictive value of (VIS) for mortality in neonates with congenital heart disease (CHD). STUDY DESIGN: Prospective cohort. PATIENTS: 119 newborns who underwent cardiac surgery. SETTING: Tertiary NICU-CHD center of Ankara from November 2016 to January 2019. INTERVENTION/MEASUREMENT: VIS values were calculated by a standard formula for the first 72 postoperative hours, and the maximum score was recorded. PRIMARY OUTCOMES: Duration of mechanical ventilation, NICU length of stay, and mortality. RESULTS: At surgery, the median (IQR) age was 15 d (9-31). The patients were divided into two groups according to mortality; Group 1 (Non-survivors) (n=36) and Group 2 (Survivors) (n=83). Higher VIS score was correlated to longer duration of mechanical ventilation (P=0.009, r=0.33), and was higher among patients who died (P=0.003). Area under the curve (AUC) was 0,83 (P<0.001, CI: 95% 0.7-0.9) for VIS to identify mortality. At a cut-off value of 15.5, sensitivity and negative predictive values of VIS for mortality were 73.6% and 85.3%, respectively. The higher VIS (>15.5) was independently associated with increased odds for mortality (OR: 8.1, 95% CI: 1.8-35.7, P=0.005). CONCLUSIONS: In newborns with CHD, a higher VIS within 72 hours after cardiac surgery is associated with increased duration of mechanical ventilation, and mortality. VIS may be useful for prediction of mortality at early postoperative period.
OBJECTIVE: Vasoactive-inotropic Score (VIS) was developed to quantify the amount of inotropic support provided in the postoperative period. We investigated the predictive value of (VIS) for mortality in neonates with congenital heart disease (CHD). STUDY DESIGN: Prospective cohort. PATIENTS: 119 newborns who underwent cardiac surgery. SETTING: Tertiary NICU-CHD center of Ankara from November 2016 to January 2019. INTERVENTION/MEASUREMENT: VIS values were calculated by a standard formula for the first 72 postoperative hours, and the maximum score was recorded. PRIMARY OUTCOMES: Duration of mechanical ventilation, NICU length of stay, and mortality. RESULTS: At surgery, the median (IQR) age was 15 d (9-31). The patients were divided into two groups according to mortality; Group 1 (Non-survivors) (n=36) and Group 2 (Survivors) (n=83). Higher VIS score was correlated to longer duration of mechanical ventilation (P=0.009, r=0.33), and was higher among patients who died (P=0.003). Area under the curve (AUC) was 0,83 (P<0.001, CI: 95% 0.7-0.9) for VIS to identify mortality. At a cut-off value of 15.5, sensitivity and negative predictive values of VIS for mortality were 73.6% and 85.3%, respectively. The higher VIS (>15.5) was independently associated with increased odds for mortality (OR: 8.1, 95% CI: 1.8-35.7, P=0.005). CONCLUSIONS: In newborns with CHD, a higher VIS within 72 hours after cardiac surgery is associated with increased duration of mechanical ventilation, and mortality. VIS may be useful for prediction of mortality at early postoperative period.
Authors: Alina Elena Gaiduchevici; Cătălin Gabriel Cîrstoveanu; Bogdan Socea; Ana Michaela Bizubac; Carmen Mariana Herișeanu; Cristina Filip; Florin Dumitru Mihălțan; Mihai Dimitriu; Florentina Jacotă-Alexe; Mihail Ceaușu; Radu-Iulian Spătaru Journal: Exp Ther Med Date: 2022-05-10 Impact factor: 2.751