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Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis

Vasoactive and inotropic medications are essential for sepsis management; however, the association between the maximum Vasoactive-Inotropic score (VISmax) and clinical outcomes is unknown in adult patients with sepsis. We investigated the VISmax as a predictor for mortality among such patients in th...

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Autores principales: Song, Juhyun, Cho, Hanjin, Park, Dae Won, Moon, Sungwoo, Kim, Joo Yeong, Ahn, Sejoong, Lee, Seong-geun, Park, Jonghak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867010/
https://www.ncbi.nlm.nih.gov/pubmed/33572578
http://dx.doi.org/10.3390/jcm10030495
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author Song, Juhyun
Cho, Hanjin
Park, Dae Won
Moon, Sungwoo
Kim, Joo Yeong
Ahn, Sejoong
Lee, Seong-geun
Park, Jonghak
author_facet Song, Juhyun
Cho, Hanjin
Park, Dae Won
Moon, Sungwoo
Kim, Joo Yeong
Ahn, Sejoong
Lee, Seong-geun
Park, Jonghak
author_sort Song, Juhyun
collection PubMed
description Vasoactive and inotropic medications are essential for sepsis management; however, the association between the maximum Vasoactive-Inotropic score (VISmax) and clinical outcomes is unknown in adult patients with sepsis. We investigated the VISmax as a predictor for mortality among such patients in the emergency department (ED) and compared its prognostic value with that of the sequential organ failure assessment (SOFA) score. This single-center retrospective study included 910 patients diagnosed with sepsis between January 2016 and March 2020. We calculated the VISmax using the highest doses of vasopressors and inotropes administered during the first 6 h on ED admission and categorized it as 0–5, 6–15, 16–30, 31–45, and >45 points. The primary outcome was 30-day mortality. VISmax for 30-day mortality was significantly higher in non-survivors than in survivors. The mortality rates in the five VISmax groups were 17.2%, 20.8%, 33.3%, 54.6%, and 70.0%, respectively. The optimal cut-off value of VISmax to predict 30-day mortality was 31. VISmax had better prognostic value than the cardiovascular component of the SOFA score and initial lactate levels. VISmax was comparable to the APACHE II score in predicting 30-day mortality. Multivariable analysis showed that VISmax 16–30, 31–45, and >45 were independent risk factors for 30-day mortality. VISmax in ED could help clinicians to identify sepsis patients with poor prognosis.
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spelling pubmed-78670102021-02-07 Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis Song, Juhyun Cho, Hanjin Park, Dae Won Moon, Sungwoo Kim, Joo Yeong Ahn, Sejoong Lee, Seong-geun Park, Jonghak J Clin Med Article Vasoactive and inotropic medications are essential for sepsis management; however, the association between the maximum Vasoactive-Inotropic score (VISmax) and clinical outcomes is unknown in adult patients with sepsis. We investigated the VISmax as a predictor for mortality among such patients in the emergency department (ED) and compared its prognostic value with that of the sequential organ failure assessment (SOFA) score. This single-center retrospective study included 910 patients diagnosed with sepsis between January 2016 and March 2020. We calculated the VISmax using the highest doses of vasopressors and inotropes administered during the first 6 h on ED admission and categorized it as 0–5, 6–15, 16–30, 31–45, and >45 points. The primary outcome was 30-day mortality. VISmax for 30-day mortality was significantly higher in non-survivors than in survivors. The mortality rates in the five VISmax groups were 17.2%, 20.8%, 33.3%, 54.6%, and 70.0%, respectively. The optimal cut-off value of VISmax to predict 30-day mortality was 31. VISmax had better prognostic value than the cardiovascular component of the SOFA score and initial lactate levels. VISmax was comparable to the APACHE II score in predicting 30-day mortality. Multivariable analysis showed that VISmax 16–30, 31–45, and >45 were independent risk factors for 30-day mortality. VISmax in ED could help clinicians to identify sepsis patients with poor prognosis. MDPI 2021-01-31 /pmc/articles/PMC7867010/ /pubmed/33572578 http://dx.doi.org/10.3390/jcm10030495 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Song, Juhyun
Cho, Hanjin
Park, Dae Won
Moon, Sungwoo
Kim, Joo Yeong
Ahn, Sejoong
Lee, Seong-geun
Park, Jonghak
Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis
title Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis
title_full Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis
title_fullStr Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis
title_full_unstemmed Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis
title_short Vasoactive-Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis
title_sort vasoactive-inotropic score as an early predictor of mortality in adult patients with sepsis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867010/
https://www.ncbi.nlm.nih.gov/pubmed/33572578
http://dx.doi.org/10.3390/jcm10030495
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