Time to Calculate the Vasoactive Inotropic Score as a Predictor of Mortality and Morbidity in Cardiac Surgery

Abstract

Objective: To determine the ideal time for calculating vasoactive inotropic score (VIS) as a reliable predictor of morbidity and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass.

Methods: The study was a prospective and cross-sectional study that took place in the Department of Anesthesia and cardiac surgery of Choudhary Pervez Ellahi Institute cardiology in Multan on 346 patients undergoing cardiac surgery with cardiopulmonary bypass. The demographic and perioperative information was taken, such as the type of surgery, cardiopulmonary bypass, and cross-clamp time. VIS was also measured at different points of the postoperative period, and the patients were observed on the clinical outcomes such as in-hospital mortality, length of mechanical ventilation, length of stay in the ICU, and renal failure, as well as low cardiac output syndrome.

Results: The mean age of patients was 56.91 ± 10.89 years, with 61.8% males. CABG was the most common procedure (57.2%). Mean cardiopulmonary bypass and aortic cross-clamp times were 112.42 ± 27.51 minutes and 73.22 ± 18.98 minutes, respectively. VIS increased over the first 24 hours postoperatively, from 9.75 ± 6.54 at ICU admission to a peak VIS of 22.64 ± 6.30. Mean ICU and hospital stays were 4.12 ± 2.21 days and 10.04 ± 4.38 days, respectively. In-hospital mortality was 9.2%, while the composite outcome of death or major morbidity occurred in 34.1% of patients. X²

Conclusion: The vasoactive inotropic score is a useful forecast of postoperative outcome in cardiac surgery and the 24-hour postoperative VIS showed the greatest predictability of mortality or morbidity. Regular VIS evaluation at this time can enhance risk classification and implement interventions on time.