Vasoactive-Inotropic Score (VIS) and Outcome of Children with Pediatric Septic Shock

To assess the effectiveness of the vasoactive-inotropic score (VIS) in predicting outcomes for pediatric sepsis.

A one-year prospective observational study in a tertiary level pediatric intensive care unit (PICU), enrolled children (1 month to 12 years) with fluid-refractory septic shock. VIS and aggregate VIS (AVIS) was calculated at 6, 12, 24, 48, 72, and 96 h post-hospitalization. The primary outcome assessed was mortality and secondary outcomes included duration of PICU stay, ventilation and inotrope support.

Ninety (64.4% male) patients with median (Q1, Q3) age of 24 [6, 60] months were enrolled. The median (Q1, Q3) duration of PICU stay (days) among survivors (n = 32) was significantly shorter 9 (7, 12) compared to non-survivors (n = 58) was 13 (9, 16) (P < 0.001). Significant correlations were found between AVIS at 96 h (AVIS96) and lactate levels (r = 0.79, P < 0.001), duration of inotrope support (r = 0.73, P < 0.001), and duration of ventilation (r = 0.69, P < 0.001). An AVIS96 cutoff of ≥ 25.4 showed high accuracy for mortality prediction (AUC 0.976, sensitivity 95%, specificity 90%), outperforming pSOFA and lactate levels.

VIS is a reliable predictor of outcomes in pediatric septic shock, with potential for early risk stratification. An AVIS96 cut-off value of 25.4 showed maximum diagnostic accuracy in terms of mortality prediction in this cohort.