Vasoactive-inotropic score as a predictor of outcome in children after cardiac surgery with bypass

Objective To evaluate the vasoactive-inotropic score(VIS) as a predictor of outcome in children following surgery for congenital heart disease. Methods A retrospective chart review of 472 children undergoing cardiac surgery with bypass. VIS values were calculated during the first 72 postoperative hours, and the maximum and mean scores in the first, second and third 24 postoperative hours[VIS(24max), VIS(24mean), VIS(48max), VIS(48mean), VIS(72max), VIS(72mean)] were also recorded. Chi-test, t-test, and ROC curves were performed for the association between VIS and the clinical outcomes. Results ROC analysis indicated the VIS(24max) was strongly associated with poor outcomes(AUROC=0.919, P=0.000). And the high VIS(24max) defined as 19.5 and above, which may lead poor outcomes(J=0.70). When the interplay between a range of factors was controlled, only lactate and VIS(24max) was related to the prognosis. Conclusion Maximum VIS calculated in the first 24 hours[VIS(24max)] after PICU admission was strongly and significantly associated with clinical outcomes in children after cardiac surgery. The greater the VIS, the worse the illness, the poorer the outcome, the higher the mortality.