Researchers wanted to see if the vasoactive-ventilation-renal score might be used to predict prognosis in individuals recovering from congenital heart surgery. They also wanted to determine when the best moment to test the vasoactive-ventilation-renal score was during the early recovery period. Between January 2015 and June 2015, they looked at a group of patients recovering from heart surgery in the intensive care unit. At 6, 12, 24, and 48 hours after surgery, the vasoactive-ventilation-renal score was calculated as follows: vasoactive-ventilation-renal score = ventilation index + vasoactive-inotrope score + Δ creatinine [change in serum creatinine from baseline*10]. The primary outcome of interest was prolonged hospital length of stay, defined as a stay that lasted longer than 25% of the time. They created Receiver operating characteristic curves for each time point, and they determined the areas under the curve with 95% CI. In addition, multivariable logistic regression modeling was used. They looked at 164 patients who were 9.25 months old on average (interquartile range, 2.6-58 months). The average length of stay was eight days (interquartile range, 5-17.5 days). The vasoactive-ventilation-renal score had the greatest area under the curve value as a predictor of prolonged length of stay (>17.5 days) at 12 hours postoperatively (area under the curve = 0.93; 95% CI, 0.89-0.97).
After adjusting for potential confounders, the 12-hour vasoactive-ventilation-renal score remained a strong predictor of prolonged hospital length of stay in multivariable regression analysis (odds ratio, 1.15; 95% CI, 1.10-1.20). The unique vasoactive-ventilation-renal score calculated in the early postoperative recovery period can strongly predict longer hospital length of stay in a heterogeneous sample of patients receiving surgery for congenital heart disease.
Reference:www.jtcvs.org/article/S0022-5223(16)30943-6/fulltext
