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. 2022 May;89(5):432-437.
doi: 10.1007/s12098-021-03846-x. Epub 2021 Jul 27.

Threshold of Inotropic Score and Vasoactive-Inotropic Score for Predicting Mortality in Pediatric Septic Shock

Dipu Kallekkattu  1 , Ramachandran Rameshkumar  2 , Muthu Chidambaram  1 , Kandamaran Krishnamurthy  3 , Tamil Selvan  1 , Subramanian Mahadevan  1
Affiliations

Threshold of Inotropic Score and Vasoactive-Inotropic Score for Predicting Mortality in Pediatric Septic Shock

Dipu Kallekkattu et al. Indian J Pediatr. 2022 May.

Abstract

Objective: To determine the threshold of the inotropic score (IS) and vasoactive-inotropic score (VIS) for predicting mortality in pediatric septic shock.

Method: This retrospective cohort study included children aged 1 mo to 13 y with septic shock, requiring vasoactive medication. The area under curve receiver operating characteristic (AUROC) was calculated using mean IS and mean VIS to predict PICU mortality, and Youden index cut points were generated. Sensitivity, specificity, and binary regression analysis were performed.

Results: A total of 176 patients were enrolled (survivor, n = 72, 41% and nonsurvivor, n = 104, 59%). For predicting the PICU mortality, AUROC (95% CI) of IS was 0.80 (0.74-0.86) [sensitivity of 88.5 (80.7-94) and specificity of 58.3 (46.1-69.8)] and AUROC of VIS was 0.88 (0.82-0.92) [sensitivity of 83.7 (75.1-90.2) and specificity of 80.6 (69.5-89)]. The respective cutoff scores of IS and VIS were 28 and 42.5. On regression analysis (adjusted odds ratio, 95% CI), illness severity (PRISM-III) (1.12, 1.05-1.12), worst lactate value (1.31, 1.08-1.58), IS (> 28) (3.98, 1.24-12.80), and VIS (> 42.5) (4.66, 1.57-13.87) independently predicted the PICU mortality (r2 = 0.625).

Conclusion: Threshold of inotropic score (> 28) and vasoactive-inotropic score (> 42.5) were independently associated with PICU mortality. In addition to IS and VIS, severity and worst lactate value independently predicted septic shock mortality in PICU.

Keywords: Blood transfusion; Children; Morbidity; Mortality; Pediatric intensive care; Predictors; Septic shock; Vasoactive–inotropic score.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
a The area under receiver operating characteristic curve for inotropic score (IS) using cutpoint of 28 was 0.80, and b for vasoactive–inotropic score (VIS) using cutpoint of 42.5 was 0.88
See this image and copyright information in PMC

Comment in

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