Predictive Value of Vasoactive-inotropic Score for Mortality in Newborns Undergoing Cardiac Surgery

• DOI: 10.1007/s13312-019-1639-7
• Publication Date: 2019-11-05T08:02:56Z
• Authors: Dilek Dilli; Hasan Akduman; Utku Arman Orun; Mehmet Tasar; Irfan Tasoglu; Seda Aydogan; Rumeysa Citli; Sercan Tak
• Keywords: Heart Defects, Congenital; Male; Infant, Newborn; Length of Stay; Respiration, Artificial; Sensitivity and Specificity; Severity of Illness Index; Survival Analysis; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Predictive Value of Tests; Clinical Decision Rules; Humans; Female; Prospective Studies; Cardiac Surgical Procedures; Follow-Up Studies

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).Prospective cohort.119 newborns who underwent cardiac surgery.Tertiary NICU-CHD center of Ankara from November 2016 to January 2019.VIS values were calculated by a standard formula for the first 72 postoperative hours, and the maximum score was recorded.Duration of mechanical ventilation, NICU length of stay, and mortality.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).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.