1. Vasoactive Inotropic Score as a Predictor of Mortality in Adult Patients With Cardiogenic Shock: Medical Therapy Versus ECMO.
- Author
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Na SJ, Chung CR, Cho YH, Jeon K, Suh GY, Ahn JH, Carriere KC, Park TK, Lee GY, Lee JM, Song YB, Hahn JY, Choi JH, Choi SH, Gwon HC, and Yang JH
- Subjects
- Aged, Female, Hospital Mortality trends, Humans, Male, Middle Aged, Prognosis, Republic of Korea epidemiology, Retrospective Studies, Shock, Cardiogenic mortality, Shock, Cardiogenic therapy, Survival Rate trends, Cardiotonic Agents therapeutic use, Extracorporeal Membrane Oxygenation, Intensive Care Units statistics & numerical data, Myocardial Contraction physiology, Shock, Cardiogenic physiopathology, Vasoconstriction physiology
- Abstract
Introduction and Objectives: This study investigated whether the vasoactive inotropic score (VIS) is independently predictive of mortality in cardiogenic shock (CS)., Methods: This study was retrospective, observational study. Patients who were admitted to the cardiac intensive care unit from January 2012 to December 2015 were screened, and 493 CS patients were finally enrolled. To quantify pharmacologic support, the patients were divided into 5 groups based on a quintile of VIS: 1 to 10, 11 to 20, 21 to 38, 39 to 85, and > 85. The primary outcome was in-hospital mortality., Results: In-hospital mortalities in the 5 VIS groups in increasing order were 8.2%, 14.1%, 21.1%, 32.0%, and 65.7%, respectively (P < .001). Multivariable analysis indicated that VIS ranges of 39 to 85 (aOR, 3.85; 95%CI, 1.60-9.22; P = .003) and over 85 (aOR, 10.83; 95%CI, 4.43-26.43; P < .001) remained significant prognostic predictors for in-hospital mortality. With multiple logistic regression to remove any confounding effects, we found that the localized regression lines regarding the odds of death intersected each other's (medical therapy alone and combined extracorporeal membrane oxygenation group) path at VIS = 130. In contrast to linear correlation between VIS and mortality for patients treated with medical therapy alone, there was little association between a VIS of 130 or more and the probability of in-hospital mortality for patients who were treated with extracorporeal membrane oxygenation., Conclusions: A high level of vasoactive inotropic support during the first 48hours was significantly associated with increased in-hospital mortality in adult CS patients., (Copyright © 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
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