Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting
Abstract Increased vasoactive-inotropic score (VIS) is a reliable predictor of mortality and morbidity after cardiac surgery. Here, we retrospectively evaluated the association between VIS and adverse outcomes in adult patients after off-pump coronary artery bypass grafting (OPCAB). We included 2149...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-07-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-16900-1 |
| _version_ | 1818014962559221760 |
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| author | Ji-Hye Kwon Seung Yeon Yoo Seonwoo Kim Hojeong Won Wooksung Kim Sukyoung Her Yu Jeong Bang Jungchan Park Jong-Hwan Lee Hyun Sung Cho Jeong-Jin Min |
| author_facet | Ji-Hye Kwon Seung Yeon Yoo Seonwoo Kim Hojeong Won Wooksung Kim Sukyoung Her Yu Jeong Bang Jungchan Park Jong-Hwan Lee Hyun Sung Cho Jeong-Jin Min |
| author_sort | Ji-Hye Kwon |
| collection | DOAJ |
| description | Abstract Increased vasoactive-inotropic score (VIS) is a reliable predictor of mortality and morbidity after cardiac surgery. Here, we retrospectively evaluated the association between VIS and adverse outcomes in adult patients after off-pump coronary artery bypass grafting (OPCAB). We included 2149 patients who underwent OPCAB. The maximal VIS was calculated for the initial 48 postoperative hours using standard formulae. The primary outcome was 1-year death. The composite adverse outcome was death, resuscitation or mechanical support, myocardial infarction, revascularization, new-onset atrial fibrillation, infection requiring antibacterial therapy, acute kidney injury, and stroke. Path-analysis was conducted using lactate and prognostic nutritional index (PNI). VIS was associated with 1-year death (odds ratio [OR] 1.07 [1.04–1.10], p < 0.001) and 1-year composite outcome (OR 1.02 [1.0–1.03], p = 0.008). In path-analysis, high VIS showed a direct effect on the increased risk of 1-year death and composite outcome. In the pathway using lactate as a mediating variable, VIS showed an indirect effect on the composite outcome but no significant effect on death. Low PNI directly affected the increased risk of 1-year death and composite outcome, and had an indirect effect on both outcomes, even when VIS was used as a mediating variable. In patients undergoing OPCAB, high VIS independently predicted morbidity and 1-year death. Patients with increased lactate levels following high VIS had an increased risk of postoperative complications, although not necessarily resulting in death. However, patients with poor preoperative nutritional status had an increased risk of unfavourable outcomes, including death, implying the importance of preoperative nutritional support. |
| first_indexed | 2024-04-14T06:50:50Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-14T06:50:50Z |
| publishDate | 2022-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d9f8b11f237844b4a668a57cb0177c7e2022-12-22T02:07:02ZengNature PortfolioScientific Reports2045-23222022-07-0112111010.1038/s41598-022-16900-1Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass graftingJi-Hye Kwon0Seung Yeon Yoo1Seonwoo Kim2Hojeong Won3Wooksung Kim4Sukyoung Her5Yu Jeong Bang6Jungchan Park7Jong-Hwan Lee8Hyun Sung Cho9Jeong-Jin Min10Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineStatistics and Data Center, Samsung Medical CenterStatistics and Data Center, Samsung Medical CenterDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Increased vasoactive-inotropic score (VIS) is a reliable predictor of mortality and morbidity after cardiac surgery. Here, we retrospectively evaluated the association between VIS and adverse outcomes in adult patients after off-pump coronary artery bypass grafting (OPCAB). We included 2149 patients who underwent OPCAB. The maximal VIS was calculated for the initial 48 postoperative hours using standard formulae. The primary outcome was 1-year death. The composite adverse outcome was death, resuscitation or mechanical support, myocardial infarction, revascularization, new-onset atrial fibrillation, infection requiring antibacterial therapy, acute kidney injury, and stroke. Path-analysis was conducted using lactate and prognostic nutritional index (PNI). VIS was associated with 1-year death (odds ratio [OR] 1.07 [1.04–1.10], p < 0.001) and 1-year composite outcome (OR 1.02 [1.0–1.03], p = 0.008). In path-analysis, high VIS showed a direct effect on the increased risk of 1-year death and composite outcome. In the pathway using lactate as a mediating variable, VIS showed an indirect effect on the composite outcome but no significant effect on death. Low PNI directly affected the increased risk of 1-year death and composite outcome, and had an indirect effect on both outcomes, even when VIS was used as a mediating variable. In patients undergoing OPCAB, high VIS independently predicted morbidity and 1-year death. Patients with increased lactate levels following high VIS had an increased risk of postoperative complications, although not necessarily resulting in death. However, patients with poor preoperative nutritional status had an increased risk of unfavourable outcomes, including death, implying the importance of preoperative nutritional support.https://doi.org/10.1038/s41598-022-16900-1 |
| spellingShingle | Ji-Hye Kwon Seung Yeon Yoo Seonwoo Kim Hojeong Won Wooksung Kim Sukyoung Her Yu Jeong Bang Jungchan Park Jong-Hwan Lee Hyun Sung Cho Jeong-Jin Min Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting Scientific Reports |
| title | Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting |
| title_full | Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting |
| title_fullStr | Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting |
| title_full_unstemmed | Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting |
| title_short | Vasoactive inotropic score as a predictor of long-term mortality in patients after off-pump coronary artery bypass grafting |
| title_sort | vasoactive inotropic score as a predictor of long term mortality in patients after off pump coronary artery bypass grafting |
| url | https://doi.org/10.1038/s41598-022-16900-1 |
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