The effects of Vasoactive-Ventilation-Renal score on pediatric heart surgery

OBJECTIVE: The effects of Vasoactive-Ventilation-Renal (VVR) score on the evaluation of pediatric heart surgery results were investigated in this study. METHODS: This retrospective study included children younger than 18 years of age who were operated for congenital heart disease between was July 1(st)- December 31(st) 2018. Patients who needed ECMO support at the first postoperative 72 hours were not included in the study group. The postoperative initial, 24(th) and 48(th)-hour Vasoactive-Inotrope Score (VIS) and VVR scores of all patients were calculated in the intensive care unit (ICU). The effects of these scores on lengthy ICU duration (PCILOS, duration more than the upper 25(th) percentile) and to the hospital mortality (before 30 days) were evaluated. RESULTS: There were 340 patients in this study. The median age was 12 months (1 day-18 years), and the median weight was 7 kg (2.5 -82 kg). 18% of the patients had single ventricle physiology. Total correction was performed in 88% of the patients. Median RACHS 1 score was 2 (1–6). PCILOS was>112 hours and total mortality was 4%. The 0(th) hour VVR ICU c index=0.73 (CI: 0.70–0.77), mortality c index=0.77 (CI: 0.69–0.85). VVR at 24(th) hour ICU c index=0.75 (CI: 0.71–0.79), mortality c index=0.86 (CI: 0.81–0.91). VVR at 48(th)-hour ICU c index=0.87 (CI: 0.82–0.92), mortality c index=0.92 (CI: 0.87–0.97). The VVR score at 48(th)-hour was a strong indicator for the prediction of both LICU duration (odds ratio [OR]: –1.44; p=0.001) and hospital mortality (OR: –1.28; p=0.001). CONCLUSION: The postoperative VVR score can be a strong determinant for the prediction of early clinical results in congenital heart disease patients, which were considerably a heterogeneous group.