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Vasoactive-inotropic score as a predictor of in-hospital mortality in out-of-hospital cardiac arrest

  • YOUNG TAECK OH1
  • JAEHOON OH2
  • SEUNG MIN PARK3
  • YU JIN KIM3
  • YOU HWAN JO3
  • HAE CHUL YANG4
  • YOUNG HWAN LEE5
  • DONG KEON LEE2

1Department of Emergency Medicine, Armed Forces Daejeon Hospital, Republic of Korea

2 Department of Emergency Medicine, Seoul National University Bundang Hospital, Republic of Korea

3 Department of Emergency Medicine, C ollege of Medicine, Hanyang University, Seoul, Republic of Korea

4 Researcher, Seoul National University Bundang Hospital, Republic of Korea

5 Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Republic of Korea

DOI: 10.22514/SV152.092019.6 Vol.15,Issue 2,September 2019 pp.40-44

Published: 20 September 2019

*Corresponding Author(s): DONG KEON LEE E-mail: stolenegg@gmail.com

Abstract

Background. The Vasoactive-Inotropic Score (VIS) is an objective clinical tool used to quantify the need for cardiovas-cular support in children and adolescents after surgery and to predict prognosis of pediatric septic shock. Considering the post-cardiac arrest syndrome (PCAS) is a sepsis-like syndrome, we aimed to inves-tigate the correlation between VIS and in-hospital mortality in out-of-hospital car-diac arrest (OHCA) patients who achieved a sustained return of spontaneous circula-tion (ROSC) and admitted to the intensive care unit (ICU).

Methods. A retrospective chart review of 504 OHCA patients who were admitted to the emergency room with OHCA from Jan 2015 to Dec 2016 was done. VIS was calculated with the recorded administra-tion rate of the drugs on electronic medi-cal record at the same time during the first 24 hours in ICU. The highest value of VIS in 24 hours (24hr-peak VIS) was used for investigating the correlation between VIS and in-hospital mortality.

Results. Among 504 OHCA patients, 166 patients were admitted to the intensive care unit and 116 patients died during hospital stay. The probability of in-hospital mortality was significantly higher when 24hr-peak VIS was higher than 33.3 [Odds ratio (OR) = 3.18, 95% CI = 1.22 – 8.29, p value = 0.018]. 

Conclusion. 24hr-Peak VIS could be a good scoring system for predicting in-hospital mortality in OHCA patients who admit-ted to ICU. The AUC was 0.762 (95% CI = 0.690 to 0.825) and the optimal cut-off values were 33.3 (sensitivity 0.764, speci-ficity 0.610).

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YOUNG TAECK OH,JAEHOON OH,SEUNG MIN PARK,YU JIN KIM,YOU HWAN JO,HAE CHUL YANG,YOUNG HWAN LEE,DONG KEON LEE. Vasoactive-inotropic score as a predictor of in-hospital mortality in out-of-hospital cardiac arrest. Signa Vitae. 2019. 15(2);40-44.

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