Vasoactive Inotropic Score (VIS) as Biomarker of Short-Term Outcomes in Adolescents after Cardiothoracic Surgery

Garcia, Richard U.; Walters, Henry L.; Delius, Ralph E.; Aggarwal, Sanjeev

doi:10.1007/s00246-015-1273-7

Cited by 60 publications

(46 citation statements)

References 24 publications

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“…13,15 Higher VIS values have also been associated with worse outcomes in septic paediatric patients. 18 The predictive performance of the VIS in adult populations has not been assessed.…”

mentioning

confidence: 99%

Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery

Koponen

Karttunen

Musialowicz

et al. 2019

British Journal of Anaesthesia

200

131

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Background: The vasoactive-inotropic score (VIS) predicts mortality and morbidity after paediatric cardiac surgery. Here we examined whether VIS also predicted outcome in adults after cardiac surgery, and compared predictive capability between VIS and three widely used scoring systems. Methods: This single-centre retrospective cohort study included 3213 cardiac surgery patients. Maximal VIS (VIS max ) was calculated using the highest doses of vasoactive and inotropic medications administered during the first 24 h postsurgery. We established five VIS max categories: 0e5, >5e15, >15e30, >30e45, and >45 points. The predictive accuracy of VIS max was evaluated for a composite outcome, which included 30-day mortality, mediastinitis, stroke, acute kidney injury, and myocardial infarction. Results: VIS max showed good prediction accuracy for the composite outcome [area under the curve (AUC), 0.72; 95% confidence interval (CI), 0.69e0.75]. The incidence of the composite outcome was 9.6% overall and 43% in the highest VIS max group (>45). VIS max predicted 30-day mortality (AUC, 0.76; 95% CI, 0.69e0.83) and 1-yr mortality (AUC, 0.70; 95% CI, 0.65e0.74). Prediction accuracy for unfavourable outcome was significantly better with VIS max than with Acute Physiology and Chronic Health Evaluation II (P¼0.01) and Simplified Acute Physiological Score II (P¼0.048), but not with the Sequential Organ Failure Assessment score (P¼0.32). Conclusions: In adults after cardiac surgery, VIS max predicted a composite of unfavourable outcomes and predicted mortality up to 1 yr after surgery.

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“…13,15 Higher VIS values have also been associated with worse outcomes in septic paediatric patients. 18 The predictive performance of the VIS in adult populations has not been assessed.…”

mentioning

confidence: 99%

Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery

Koponen

Karttunen

Musialowicz

et al. 2019

British Journal of Anaesthesia

200

131

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“…According to cutoff> 4.75, the area under the ROC for the max VIS was 0.76, while the sensitivity, specificity, positive predictive value and negative predictive value were 67%, 74%, 36% and 91%, respectively. It has been proposed that this simple score can be used as a prognostic indicator (18). In our previous study in which the relationship between VIS score and mortality in patients with severe head trauma followed in adult intensive care unit was 72.7%, 74.1%, 68.1% and 78.2% for the cutoff value of mean VIS ≥7.5, respectively (19).…”

Section: Discussionmentioning

confidence: 98%

“…The median ages of the patients were 68 (54.2-79) years, and 239 (61%) were male. Median Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) values were 24.5 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27) and 11 (9)(10)(11)(12), respectively. While the duration of ICU stay was 10(4-22) days, the rates of patients with invasive mechanical ventilation, blood and blood products transfusion and acute kidney injury were 96.9% (380 patients), 58.9% (231 patients) and 26.3% (103 patients), respectively.…”

Section: General Characteristics Of Patients With Sepsis / Septic Shockmentioning

confidence: 99%

The use of Vasoactive-Inotropic Score in Adult Patients with Septic Shock in Intensive Care

Kara¹,

Sargın²,

Bayraktar³

et al. 2019

Yoğun Bakım Derg

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Objective: Sepsis and septic shock are significant causes of mortality and morbidity. In septic shock, vasopressors and inotropic support are given for the treatment of hypotension. This study was designed to investigate the relationship between the vasoactive-inotropic score (VIS) and the results of sepsis patients in ICU. Methods: The data of 392 patients who were followed up with the diagnosis of septic shock in adult ICU were recorded retrospectively. Vasopressors and inotropic support of the patients during the first 48 hours after the diagnosis of septic shock were recorded. Mean and peak VIS values were calculated according to these values. The patients were divided into groups according to the mean VIS≥10, peak VIS≥10 and intensive care results and statistical analysis was performed. Results: The median ages of the patients were 68 (54.25-79) years and 239 (61%) were male. Dopamine 188 (47.9%), noradrenaline 365 (93.1%), adrenaline 53 (13.5%) and dobutamine 15 (3.8%) were used in the patients. The mean VIS was 9 (4-15), while the number of mean VIS≥10 patients were 192 (49%). Peak VIS values were 11 (5-20), and the number of peak VIS ≥10 patients were 220 (56.1%). The mortality rate of the patients included in the study was 42.1%. The mean VIS score(13 vs 6, p=0.000), mean VIS≥10 patient ratio (71.5% vs 32.6%, p=0.000), peak VIS score (16 vs 8, p=0.000), and peak VIS ≥10 patient ratio (73.3% vs 43.6%, p=0.000) were higher in non-survivors. The parameters such as mean VIS [OR 1.123, 95% CI 1.027-1.229, p=0.011], mean VIS≥10 [OR 3.455, 95% CI 1.625-7.345, p=0.001] and peak VIS score [OR 0.917, 95% CI 0.851-0.989, p=0.024] were determined as independent risk factors for mortality. Conclusion: We conclude that vasoactive-inotropic score may be useful in predicting the outcome of septic shock patients in intensive care units.

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“…Therefore, the patients in the study were high-risk. VIS score was initially used in newborns and infants after cardiac surgery but in recent years has gradually been used in adults and adolescents (25) during the perioperative period of cardiac surgery to evaluate degree of critical illness. Relative to the complexity of APACHE II, the calculation method of VIS score is simpler and quicker (26).…”

Section: Discussionmentioning

confidence: 99%

Clinical application of intra-aortic balloon pump in patients with cardiogenic shock during the perioperative period of cardiac surgery

Jiang

Zhu

et al. 2017

Experimental and Therapeutic Medicine

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Intra-aortic balloon pumps (IABP) have saved many patients with cardiogenic shock during the perioperative period of cardiac surgery. However, the ideal insertion timing is controversial. In the present study, we aimed to optimize the insertion timing, in order to increase the survival rate of the patients. A total of 197 patients with cardiogenic shock during the perioperative period of cardiac surgery and implemented IABP from January 2011 to October 2015 were selected for the study. Patients were divided into five groups on the basis of application timing of IABP: 0–60, 61–120, 121–180, 181–240 and >240 min. The 30-day mortality, application rate of continuous renal replacement therapy (CRRT), duration of mechanical ventilation, duration of hospital stay and hospitalization charges were analyzed in the above groups. The risk factors related to mortality and the occurrence of IABP complications were also analyzed. The mortality in the 0–60, 61–120, 121–180, 181–240 and >240 min groups were 42.17, 36.6, 77.3, 72.7 and 79.3%, respectively. Earlier IABP insertion resulted in less patients receiving CRRT from acute renal failure and less daily hospitalization charges. However, the IABP application timing had no effect on indexes such as hospitalization duration, duration of mechanical ventilation and total hospitalization charges. Multifactor logistic regression analysis indicated that the independent risk factors of death in patients with cardiogenic shock during cardiac surgery were related to IABP support timing and vasoactive-inotropic score (VIS) before balloon insertion. In the first 120 min of cardiogenic shock during the perioperative period of cardiac surgery, IABP application decreased 30-day mortality. Mortality was related with VIS score of patients, which can be used to predict the prognosis of patients with cardiogenic shock.

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Vasoactive Inotropic Score (VIS) as Biomarker of Short-Term Outcomes in Adolescents after Cardiothoracic Surgery

Cited by 60 publications

References 24 publications

Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery

Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery

The use of Vasoactive-Inotropic Score in Adult Patients with Septic Shock in Intensive Care

Clinical application of intra-aortic balloon pump in patients with cardiogenic shock during the perioperative period of cardiac surgery

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