Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis
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 th...
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doaj-51737cc7c1b64fbfb5f747d49628435d2021-02-01T00:01:46ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-011049549510.3390/jcm10030495Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with SepsisJuhyun Song0Hanjin Cho1Dae Won Park2Sungwoo Moon3Joo Yeong Kim4Sejoong Ahn5Seong-geun Lee6Jonghak Park7Department of Emergency Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaDepartment of Emergency Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaDivision of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaDepartment of Emergency Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaDepartment of Emergency Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaDepartment of Emergency Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaDepartment of Emergency Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaDepartment of Emergency Medicine, Korea University Ansan Hospital, Gyeonggi-do 15355, KoreaVasoactive 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.https://www.mdpi.com/2077-0383/10/3/495vasopressorsinotropessepsisseptic shockmortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juhyun Song Hanjin Cho Dae Won Park Sungwoo Moon Joo Yeong Kim Sejoong Ahn Seong-geun Lee Jonghak Park |
spellingShingle |
Juhyun Song Hanjin Cho Dae Won Park Sungwoo Moon Joo Yeong Kim Sejoong Ahn Seong-geun Lee Jonghak Park Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis Journal of Clinical Medicine vasopressors inotropes sepsis septic shock mortality |
author_facet |
Juhyun Song Hanjin Cho Dae Won Park Sungwoo Moon Joo Yeong Kim Sejoong Ahn Seong-geun Lee Jonghak Park |
author_sort |
Juhyun Song |
title |
Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis |
title_short |
Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis |
title_full |
Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis |
title_fullStr |
Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis |
title_full_unstemmed |
Vasoactive–Inotropic Score as an Early Predictor of Mortality in Adult Patients with Sepsis |
title_sort |
vasoactive–inotropic score as an early predictor of mortality in adult patients with sepsis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-01-01 |
description |
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. |
topic |
vasopressors inotropes sepsis septic shock mortality |
url |
https://www.mdpi.com/2077-0383/10/3/495 |
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