The Utility of the Vasoactive-Inotropic Score and Its Nomogram in Guiding Postoperative Management in Heart Transplant Recipients

Overview

Journal Transpl Int

Specialty General Surgery

Date 2024 Aug 9

PMID 39119063

Authors

Tixiusi Xiong

Wai Yen Yim

Jiangyang Chi

Yixuan Wang

Hongwen Lan

Jing Zhang

Yongfeng Sun

Jiawei Shi

Si Chen

Nianguo Dong

Affiliations

Soon will be listed here.

Abstract

Background: In the early postoperative stage after heart transplantation, there is a lack of predictive tools to guide postoperative management. Whether the vasoactive-inotropic score (VIS) can aid this prediction is not well illustrated.

Methods: In total, 325 adult patients who underwent heart transplantation at our center between January 2015 and December 2018 were included. The maximum VIS (VIS) within 24 h postoperatively was calculated. The Kaplan-Meier method was used for survival analysis. A logistic regression model was established to determine independent risk factors and to develop a nomogram for a composite severe adverse outcome combining early mortality and morbidity.

Results: VIS was significantly associated with extensive early outcomes such as early death, renal injury, cardiac reoperation and mechanical circulatory support in a grade-dependent manner, and also predicted 90-day and 1-year survival ( < 0.05). A VIS-based nomogram for the severe adverse outcome was developed that included VIS, preoperative advanced heart failure treatment, hemoglobin and serum creatinine. The nomogram was well calibrated (Hosmer-Lemeshow = 0.424) with moderate to strong discrimination (C-index = 0.745) and good clinical utility.

Conclusion: VIS is a valuable prognostic index in heart transplantation. In the early post-transplant stage, this VIS-based nomogram can easily aid intensive care clinicians in inferring recipient status and guiding postoperative management.

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