Escala vasoactivo-inotrópica como factor pronóstico en pacientes pediátricos intervenidos con cirugía cardiovascular

Abstract

ObjectiveTo determine the relationship between the presenting of a major adverse event (MAE) in children who have undergone cardiac surgery using the vasoactive inotrope score (VIS) in the post-operative period in the Paediatric Intensive Care Unit (PICU). MethodsThis study is an analytical observational single-centre study of a retrospective cohort of paediatric patients from 0 to 17 years admitted to PICU in the post-operative period of cardiac surgery.Differences were found between the sub-groups established according to the VIS, using the Pearson Chi2, Mann Whitney U, or Student t tests (continuous variables). A survival analysis was performed using the MAE outcome variable. Log-rank test and Kaplan Meier curves for those variables with significant differences in the log-rank test and those chosen for construction of a Cox model. Hazard ratios (HR) for the selected variables were also calculated. ResultsAn MAE was presented in 37.5% of patients (75 events), with a mean time of presentation of 15.06h, with a median of 14h, IQ25-75 (3-24). The VIS at 0h was a risk factor for the presentation of MAE, with a HR = 3.05 (95% CI: 1.81-5.01, P=.0001). The transfusions per kilogram variable constituted one of the important findings in this study as a positive association with the occurrence of a MAE, with a HR = 1.005 (95% CI: 0.99-1.0, P=.09). ConclusionsThe vasoactive inotrope score on admission to the PICU is a risk factor of presenting with a MAE.