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Published on: November 28, 2018
Predictive Value of Vasoactive-inotropic Score for Mortality in Newborns Undergoing Cardiac Surgery
Dilek Dilli1, Hasan Akduman2, Utku Arman Orun3
1Department 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.
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.
