Vasoactive-Inotropic Score as the predictor for postoperative acute
kidney injury in patients with cardiovascular surgery
OBJECTIVE: The aim of this study was to evaluate the
vasoactive-inotropic score (VIS) as the predictor for postoperative
acute kidney injury (AKI) in adult patients with cardiovascular surgery.
DESIGN: Retrospective cohort study. SETTING: Single center.
PARTICIPANTS: 1935 adult patients with cardiovascular surgery between
September 2017 and May 2019. MEASUREMENTS AND MAIN RESULTS: We
calculated VIS-max by using the highest doses of vasoactive and
inotropic medications during the first 24h after cardiovascular surgery.
In 1935 patients, 291 patients (15.0%) developed postoperative AKI from
second day to seventh day after cardiovascular surgery, and 30 patients
(1.6%) needed RRT. Multivariate logistic regression analysis showed
that VIS-max was associated with postoperative AKI (odds ratio[OR]:
1.18, 95% confidence interval [CI]: 1.10-1.27, P<0.001)
and need for RRT in AKI patients (OR: 1.04, 95%CI: 1.01-1.06, P=0.004).
The area under the ROC curve (AUC) of VIS-max as a continuous variable
was significantly than the AUC of EuroSOCRE, SOFA or APACHE II score as
continuous variables ( VIS-max vs EuroSCORE: 0.81 vs 0.71,
P<0.001, VIS-max vs SOFA score: 0.81 vs 0.67,
P<0.001, VIS-max vs APACHE II score: 0.81 vs 0.68,
P<0.001), and the optimal cutpoint of VIS-max was 7.5 points.
The AUC of VIS-max for predicting need for RRT in patients with
postoperative AKI was significantly higher than EuroSOCRE (0.75 vs 0.58,
P=0.024), and the cut-off value was 12.5 points. CONCLUSIONS: VIS-max
may be a useful tool in predicting postoperative AKI in adult patients
after cardiovascular surgery.