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Journal of Anesthesia
Published in: Journal of Anesthesia 2/2018

01-04-2018 | Original Article

Vasoactive-inotropic score as a predictor of morbidity and mortality in adults after cardiac surgery with cardiopulmonary bypass

Authors: Yumiko Yamazaki, Koji Oba, Yoshiro Matsui, Yuji Morimoto

Published in: Journal of Anesthesia | Issue 2/2018

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Abstract

Purpose

The vasoactive-inotropic score (VIS) is a scale showing the amount of vasoactive and inotropic support. Recently, it was suggested that the VIS after cardiac surgery predicts morbidity and mortality in infants. The purpose of this study was to evaluate the VIS at the end of surgery as a predictor of morbidity and mortality in adult cardiac surgery.

Methods

A retrospective cohort study of 129 adult cardiac surgery patients was performed at a university hospital. The primary outcome was termed “poor outcome”, which was a composite of morbidity and mortality. The secondary outcomes were the duration of intensive care unit (ICU) stay and time to first extubation. Multivariate logistic regression analysis was performed to evaluate the association between the VIS and poor outcomes. A proportional hazards model was used to evaluate the duration of the ICU stay and time to first extubation.

Results

After adjusting for the EuroSCORE, preoperative ejection fraction, and bypass time, a high VIS at the end of surgery was associated with a poor outcome with an adjusted odds ratio of 4.87 (95% confidence interval 1.51–18.94; p = 0.007). After controlling for the EuroSCORE and bypass time, patients with a high VIS experienced longer ICU stay (hazard ratio 1.62; 95% confidence interval 1.10–2.39; p = 0.015) and needed longer ventilation (hazard ration 1.87; 95% confidence interval 1.28–2.74, p = 0.001).

Conclusions

The amount of cardiovascular support at the end of cardiac surgery may predict morbidity and mortality in adults.
Appendix
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Metadata
Title
Vasoactive-inotropic score as a predictor of morbidity and mortality in adults after cardiac surgery with cardiopulmonary bypass
Authors
Yumiko Yamazaki
Koji Oba
Yoshiro Matsui
Yuji Morimoto
Publication date
01-04-2018
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 2/2018
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-018-2447-2

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