AUTHOR=Xiong Tixiusi , Yim Wai Yen , Chi Jiangyang , Wang Yixuan , Lan Hongwen , Zhang Jing , Sun Yongfeng , Shi Jiawei , Chen Si , Dong Nianguo 

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

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.11354

DOI=10.3389/ti.2024.11354

ISSN=1432-2277

ABSTRACT=In the early postoperative stage after heart transplantation, there is a lack of prediction tool to guide postoperative management. Whether vasoactive-inotropic score (VIS) can aid this prediction is not well illustrated. Methods: 325 adult patients who underwent heart transplantation in our center between January, 2015 and December, 2018 were included. The maximal VIS (VISmax) within postoperative 24 hours was calculated. Kaplan-Meier method were used for survival analysis. Logistic regression model was established to determine independent risk factors and develop a nomogram for a composite severe adverse outcome combining early mortality and morbidity. Results: VISmax 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 (P<0.05). A VIS based nomogram for the severe adverse outcome was developed containing VISmax, preoperative advanced heart failure treatment, hemoglobin and serum creatinine. The nomogram was well calibrated (Hosmer-Lemeshow P=0.424) with a moderate to strong discrimination (C-index=0.745) and good clinical utility. Conclusion: VISmax 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.