The value of vasoactive inotropic score in assessing neonatal early-onset sepsis outcomes
10.3760/cma.j.cn113903-20240524-00370
- VernacularTitle:血管活性正性肌力药物评分在新生儿早发型败血症结局评估中的价值
- Author:
Xia ZHANG
1
;
Mingling CUI
;
Zuming YANG
;
Zongtai FENG
Author Information
1. 南京医科大学附属苏州医院（苏州市立医院）新生儿科，苏州 215002
- Publication Type:Journal Article
- Keywords:
Neonate;
Early-onset sepsis;
Vasoactive inotropic score;
Receiver operating characteristics
- From:
Chinese Journal of Perinatal Medicine
2025;28(4):320-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of vasoactive inotropic score (VIS) in assessing adverse outcomes in neonates with early-onset sepsis (EOS).Methods:A retrospective study was conducted on 110 neonates with EOS admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from January 2020 to March 2024. The patients were divided into a survival group ( n=88) and a death group ( n=22). Perinatal factor, and complications were compared between the two groups using t test, Mann-Whitney U test, and Chi-square test. Logistic regression analysis was used to identify the risk factors for death in patients with EOS, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of VIS for death in EOS patients. Results:The gestational age and birth weight of the death group were lower than those of the survival group [29.4 (26.8-35.3) weeks vs. 32.8 (30.1-37.2) weeks, 1 050.0 (737.5-2 162.5) g vs. 1 700.0 (1 212.5-2 587.5) g, Z values were－2.16 and－2.30, both P<0.05]. Compared with the survival group, the proportion of asphyxia [45.5% (10/22) vs. 21.6% (19/88)], low temperature [27.3% (6/22) vs. 8.0% (7/88)], mechanical ventilation [100.0% (22/22) vs. 54.5% (48/88)], disseminated intravascular coagulation [22.7% (5/22) vs. 3.4% (3/88)], persistent pulmonary hypertension [36.4% (8/22) vs. 11.4% (10/88)] and pulmonary hemorrhage [40.9% (9/22) vs. 8.0% (7/88)] were higher in the death group ( χ2=5.16, 4.59, 15.71, 7.09, 6.32 and 12.84, all P<0.05). The VIS values at 24 hours and 48 hours after admission in the death group were 15.0 (10.0-18.1) and 18.8 (12.8-30.0), respectively, which were higher than those in the survival group [10.0 (7.5-10.0) and 10.0 (7.5-10.0), Z values were－4.60 and－4.94, respectively, both P<0.05].Logistic regression analysis showed that 24-h VIS value ( OR=1.163, 95% CI: 1.018-1.328), 48-h VIS value ( OR=1.114, 95% CI: 1.031-1.204), birth asphyxia ( OR=3.815, 95% CI: 1.017-14.310), and pulmonary hemorrhage ( OR=4.470, 95% CI: 1.174-17.017) were independent risk factors for death (all P<0.05). ROC curve analysis showed that the optimal cutoff value for predicting death was 11 for 24-h VIS, with an area under the curve (AUC) of 0.807, Youden's index of 0.466, sensitivity of 68.2%, and specificity of 78.4%, and 12.5 for 48-h VIS, with an AUC of 0.851, Youden's index of 0.659, sensitivity of 95.5%, and specificity of 70.5%. Conclusions:The VIS value after the onset of EOS is closely related to the outcome. A 48-h VIS value exceeding 12.5 is associated with a high risk of death.
