The effects of Vasoactive-Ventilation-Renal score on pediatric heart surgery

Abstract

OBJECTIVE: The effects of Vasoactive-Ventilation-Renal (VVR) score on the evaluation of pediatric heart surgery resultswere investigated in this study.METHODS: This retrospective study included children younger than 18 years of age who were operated for congenital heartdisease between was July $1^{st}$- December $31^{st}$ 2018. Patients who needed ECMO support at the first postoperative 72 hourswere not included in the study group. The postoperative initial, $24^{th}$ and $48^{th}$-hour Vasoactive-Inotrope Score (VIS) and VVRscores of all patients were calculated in the intensive care unit (ICU). The effects of these scores on lengthy ICU duration(PCILOS, duration more than the upper $25^{th}$ percentile) and to the hospital mortality (before 30 days) were evaluated.RESULTS: There were 340 patients in this study. The median age was 12 months (1 day-18 years), and the median weightwas 7 kg (2.5 -82 kg). 18% of the patients had single ventricle physiology. Total correction was performed in 88% of thepatients. Median RACHS 1 score was 2 (1–6). PCILOS was>112 hours and total mortality was 4%. The 0th hour VVR ICUc index=0.73 (CI: 0.70–0.77), mortality c index=0.77 (CI: 0.69–0.85). VVR at $24^{th}$ hour ICU c index=0.75 (CI: 0.71–0.79),mortality c index=0.86 (CI: 0.81–0.91). VVR at $48^{th}$-hour ICU c index=0.87 (CI: 0.82–0.92), mortality c index=0.92 (CI:0.87–0.97). The VVR score at $48^{th}$-hour was a strong indicator for the prediction of both LICU duration (odds ratio [OR]:–1.44; p=0.001) and hospital mortality (OR: –1.28; p=0.001).CONCLUSION: The postoperative VVR score can be a strong determinant for the prediction of early clinical results in congenital heart disease patients, which were considerably a heterogeneous group.