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Validation of the Vasoactive-Ventilation-Renal Score as a Predictor of Prolonged Intensive Care Unit Stay and Mortality After Critical Congenital Heart Surgery in Neonates
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  • Umut Zübarioğlu,
  • Ozgur Yildirim,
  • Cenap Zeybek,
  • İsmail Balaban,
  • Bahruz Aliyev,
  • Shiraslan Bakhshaliyev ,
  • volkan yazıcıoğlu
Umut Zübarioğlu
Yeni Yuzyil University
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Ozgur Yildirim
Yeni Yuzyil University
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Cenap Zeybek
Yeni Yuzyil University
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İsmail Balaban
Yeni Yuzyil University
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Bahruz Aliyev
Yeni Yuzyil University
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Shiraslan Bakhshaliyev
Yeni Yuzyil University
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volkan yazıcıoğlu
Yeni Yuzyil University
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Abstract

Objectives: We aimed to validate the vasoactive-ventilation-renal (VVR) score and to compare with other indices as a predictor of outcome in neonates recovering from surgery for critical congenital heart disease. We also sought to determine the optimal time at which VVR score should be measured. Methods: We retrospectively reviewed neonates recovering from cardiac surgery between July 2017 and June 2020. The VVR score was calculated at admission, 24, 48 and 72 hours postoperatively. Max values, defined as the highest of the four measurements were also noted. Main outcome of interest was composite outcome which is prolonged intensive care unit stay plus mortality. Receiver operating characteristic curves were generated, and areas under the curve with 95% confidence intervals were calculated for all time points. Multivariable logistic regression modelling was also performed. Results: We reviewed 73 neonates and 21 of patients had composite outcome. The area under the curve value for VVR score as a predictor of composite outcome was greatest at postoperative 72 hour max (AUC= 0,967; 95% confidence interval, (0,927-1). On multivariable regression analysis, the VVR max 72 hour VVR score remained a strong independent predictor of prolonged ICU stay and mortality (odds ratio, 1.4 52; 95% confidence interval, 1.036 – 2.035). Conclusions: We validated the utility of the VVR score in neonatal cardiac surgery for critical congenital heart disease. The VVR follow up in postoparative 72 hours is superior to other indeces and especially the maximum VVR value is potentially powerful clinical tool to predict ICU stay and mortality.