Department of Anesthesiology and Reanimation, Giresun University Faculty of Medicine, Giresun, Turkey.
Department of Cardiovascular Surgery, Giresun University Faculty of Medicine, Giresun, Turkey.
Ann Card Anaesth. 2024 Jan 1;27(1):37-42. doi: 10.4103/aca.aca_127_23. Epub 2024 Jan 12.
The aim of this study was to evaluate the prediction of vasoactive inotropic score (VIS) on early mortality and morbidity after coronary artery bypass grafting (CABG) and to determine the ideal time for score calculation.
The study included patients who underwent isolated on-pump CABG surgery between November 2021 and November 2022. Pre, intra, and postoperative data were obtained by retrospective chart review. The final VIS value in the operating room (VISintra) and the highest VIS value in the first 24 hours in the intensive care unit (VISmax) were calculated. The patients were divided into two groups; Group 1 who developed early postoperative morbidity and mortality and Group 2 who did not. And the data were analyzed by groups.
A total of 221 patients with a mean age of 63.49 ± 9.96 years were evaluated and 73 (33%) were in Group 1. The cut-off value for VISintra was determined to be 6.20, VISmax was 6,05. VISintra and VISmax values were significantly higher in the poor outcome group. Multivariate analysis showed that only VISmax value was an independent variable on mortality-morbidity.
Our results imply that the vasoactive inotropic score is an easy and inexpensive score to calculate and can be used as a specific scoring system to predict poor early outcomes in CABG patients. According to statistical analyses, the most predictive time among VIS measurements was VISmax, the highest value calculated in the ICU in the first 24 hours postoperatively.
本研究旨在评估血管活性正性肌力评分(VIS)对冠状动脉旁路移植术(CABG)后早期死亡率和发病率的预测作用,并确定评分计算的理想时间。
本研究纳入 2021 年 11 月至 2022 年 11 月期间接受单纯体外循环 CABG 手术的患者。通过回顾性病历查阅获取术前、术中和术后数据。在手术室计算最终 VIS 值(VISintra)和重症监护病房(ICU)内 24 小时内的最高 VIS 值(VISmax)。根据术后早期发生的发病率和死亡率,将患者分为两组:发生早期术后发病率和死亡率的第 1 组(Group 1)和未发生的第 2 组(Group 2)。并对两组数据进行分析。
共评估了 221 例平均年龄为 63.49 ± 9.96 岁的患者,其中 73 例(33%)患者为 Group 1。确定 VISintra 的截断值为 6.20,VISmax 为 6.05。不良结局组的 VISintra 和 VISmax 值显著更高。多变量分析表明,只有 VISmax 值是死亡率和发病率的独立变量。
我们的结果表明,血管活性正性肌力评分是一种易于计算且经济实惠的评分方法,可作为预测 CABG 患者早期不良结局的特定评分系统。根据统计分析,在 VIS 测量中最具预测性的时间是 VISmax,即术后 24 小时内 ICU 中计算的最高值。