Vasoactive inotropic score to predict mortality in neonatal septic shock

Objectives: Neonatal septic shock is a life-threatening condition with high mortality, necessitating reliable predictors for early risk stratification and timely intervention. The vasoactive inotropic score (VIS) quantifies the degree of cardiovascular support and may serve as a valuable prognostic tool in this context. To evaluate the utility of the VIS and its maximum value (VISmax) as predictors of mortality in neonates diagnosed with septic shock. Material and Methods: This observational study included neonates with a clinical diagnosis of septic shock. VIS and VISmax were calculated based on the dosage of vasoactive and inotropic agents administered. The association between VIS thresholds and mortality was analysed using statistical methods, including receiver operating characteristic curves to determine predictive accuracy. Results: An Inotropic Score ≥32 was significantly associated with increased mortality ( P = 0.001), with excellent predictive power (area under curve [AUC] = 96%; 95% confidence interval [CI]: 91–100%). Similarly, VISmax ≥30 was significantly associated with higher mortality risk ( P = 0.001), with a strong predictive value (AUC = 80%; 95% CI: 62–98%). These findings underscore the prognostic significance of both peak and sustained inotropic support requirements in critically ill neonates. Conclusion: The VIS and VISmax are reliable, practical predictors of mortality in neonatal septic shock. Higher scores are strongly associated with worse outcomes, indicating that these parameters can aid clinicians in early identification of high-risk neonates and guide timely escalation of care. Further multicentre studies with larger sample sizes are recommended to validate these findings and enhance their clinical applicability.