Vasoactive-inotropic score/inotropic score and short-term outcomes in pediatrics undergoing cardiac surgery: A retrospective analysis from single center.

Abstract

This study aimed to investigate the association between vasoactive-inotropic score/inotropic score (VIS/IS) and short-term outcomes in pediatric patients after cardiac surgery at a tertiary care center in an unselected pediatric population in China. This study carried out retrospective observation of 401 patients between April and June 2021 at a tertiary care center. VIS and IS were assessed intraoperatively (VIS-op, IS-op) and 2 h (VIS2h, IS2h), 24 h (VIS24h, IS24h), and 48 h (VIS48h, IS48h) postoperatively. The primary outcome was prolonged mechanical ventilation (PMV). Secondary outcomes included poor prognosis and length of stay in the pediatric intensive care unit and hospital. Mean age of the included pediatric patients was 26.5 months. Pediatric cardiac procedures were performed within an average operation duration of 167.6 ± 70.8 min. Overall, the PMV group (n = 93) experienced significantly longer ACC duration, cardiopulmonary bypass duration, operation duration, and a higher prevalence of fluid accumulation overload than the non-PMV group (n = 93). Multivariate logistic regression analysis revealed that longer operation duration (odds ratio [OR]: 1.015; 95% confidence interval [95%CI]: 1.003, 1.026; p = .012) and higher VIS48h (OR: 1.188; 95% CI: 1.077, 1.311; p = .001) were strongest predictors for PMV. VIS48h had better discrimination power for PMV than other time intervals, and the area under the curve was 0.780 (95% CI, 0.721, 0.839; p = .000). VIS48h independently predicted short-term outcomes after cardiac surgery in an unselected pediatric population in China and showed better prediction accuracy and discrimination capability than other time intervals.