A Novel Clinical Risk Score to Predict Vasoplegia After Adult Cardiac Surgery

Area of Science:

• Cardiovascular Surgery
• Anesthesiology
• Critical Care Medicine

Background:

• Vasoplegia is a serious complication following cardiopulmonary bypass (CPB).
• Current methods for identifying at-risk patients are limited by inconsistent vasoplegia definitions.
• A more precise definition led to the development of a novel risk score.

Purpose of the Study:

• To develop and validate a clinical risk score for predicting vasoplegia after CPB.
• To stratify patients into risk categories based on their likelihood of developing vasoplegia.

Main Methods:

• Electronic health records from adult CPB patients (2017-2022) were analyzed.
• Vasoplegia was rigorously defined (MAP ≤65 mm Hg, CI ≥2.2 L/min/m², norepinephrine ≥0.1 μg/kg/min, CVP ≤15 mm Hg for ≥1 hour).
• A risk score was created using regression coefficients and internally validated.

Main Results:

• The incidence of postoperative vasoplegia was 16.7%.
• Vasoplegic patients experienced higher in-hospital mortality and major morbidity.
• The risk score effectively stratified patients: low (3.9%), moderate (14.8%), and high (34.2%) vasoplegia probability.

Conclusions:

• A validated clinical risk score can identify patients at high risk for vasoplegia post-CPB.
• This score can guide clinical decision-making and facilitate timely interventions.
• Improved risk stratification may enhance patient outcomes after cardiac surgery.