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. 2021 Jan 31;10(3):495.
doi: 10.3390/jcm10030495.

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

Juhyun Song  1 , Hanjin Cho  1 , Dae Won Park  2 , Sungwoo Moon  1   3 , Joo Yeong Kim  1 , Sejoong Ahn  1 , Seong-Geun Lee  1 , Jonghak Park  1
Affiliations

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

Juhyun Song et al. J Clin Med. .

Abstract

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.

Keywords: inotropes; mortality; sepsis; septic shock; vasopressors.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of the study population. ED: emergency department; SSC: Surviving Sepsis Campaign; ECMO: extracorporeal membrane oxygenation; VIS: Vasoactive-Inotropic score.
Figure 2
Figure 2
Kaplan–Meier survival curve of each VIS group. VIS: Vasoactive-Inotropic score.
See this image and copyright information in PMC

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