Department of Anesthesiology and Reanimation, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Turkey.
Braz J Cardiovasc Surg. 2021 Dec 3;36(6):802-806. doi: 10.21470/1678-9741-2020-0219.
We aimed to investigate whether vasoactive-inotropic score (VIS) is a predictor for early postoperative morbidity and mortality.
This study was planned as a prospective cohort study, between Nov 20 2018 and May 15 2019, including a total of 290 patients aged 20 years or older who underwent elective on-pump coronary artery bypass grafting (CABG). Patients' demographic data, aortic cross-clamp and cardiopulmonary bypass times, European System for Cardiac Operative Risk Evaluation (EuroSCORE) score, cardiac ejection fraction (EF), VIS, intubation duration, and intensive care unit length of stay were recorded. Postoperative mortality and morbidity were recorded. Hourly doses of inotropes for VIS were recorded for each patient, and VIS was calculated.
Among the cases, 222 (77%) were male and 68 (23%) were female. The mean age of our patients was 62.5 years (37-86). Combined morbidity and mortality rates of our patients were 23.8%. An optimal cutoff point for VIS of 5.5 could predict combined morbidity and mortality with 90% sensitivity and 88% specificity. Low EF, prolonged operation time, high EuroSCORE, and high VIS are independent factors in the early postoperative period for the development of combined morbidity and mortality in patients who underwent elective CABG.
VIS is the most critical and EuroSCORE is the second most important scoring systems. They independently predict combined morbidity and mortality in undergoing elective coronary artery bypass surgery.
我们旨在研究血管活性-正性肌力评分(VIS)是否是术后早期发病率和死亡率的预测因素。
本研究计划为前瞻性队列研究,于 2018 年 11 月 20 日至 2019 年 5 月 15 日进行,共纳入 290 名年龄在 20 岁或以上的择期体外循环冠状动脉旁路移植术(CABG)患者。记录患者的人口统计学数据、主动脉阻断和体外循环时间、欧洲心脏手术风险评估系统(EuroSCORE)评分、心脏射血分数(EF)、VIS、插管时间和重症监护病房停留时间。记录术后死亡率和发病率。记录每位患者 VIS 的每小时正性肌力药物剂量,并计算 VIS。
在这些病例中,222 例(77%)为男性,68 例(23%)为女性。患者的平均年龄为 62.5 岁(37-86 岁)。患者的总发病率和死亡率为 23.8%。VIS 为 5.5 的最佳截断值可预测合并发病率和死亡率,敏感性为 90%,特异性为 88%。EF 降低、手术时间延长、EuroSCORE 高和 VIS 高是择期 CABG 患者术后早期合并发病率和死亡率的独立因素。
VIS 是最关键的评分系统,EuroSCORE 是第二重要的评分系统。它们独立预测择期冠状动脉旁路手术患者的合并发病率和死亡率。