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Journal of chemical health risks
By Srinidhi S Hegde.
Acute kidney injury (AKI) is a frequent complication after cardiac surgery. The maximum Vasoactive-Inotropic Score (VIS-max) may provide an early marker of postoperative haemodynamic instability and renal risk.
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To evaluate VIS-max during the first six postoperative hours as a predictor of AKI in adults undergoing elective cardiac surgery, assess its performance across surgical categories, and determine its relationship with renal replacement therapy (RRT).
This prospective observational study included 80 adults undergoing elective coronary artery bypass grafting (CABG), valvular surgery, or combined CABG and valvular surgery. Demographic, anthropometric, comorbidity, and renal parameters were recorded. VIS-max was calculated from the highest vasoactive and inotropic requirements during the first six postoperative hours. Kidney function, urine output, electrolytes, and arterial blood gas parameters were monitored. AKI was defined and staged according to KDIGO criteria.
Postoperative AKI developed in 18 patients (22.5%): 12 had stage 1, four stage 2, and two stage 3 AKI; two patients (2.5%) required RRT. Median VIS-max was significantly higher in patients with AKI than in those without AKI [13.0 (IQR 7.4–15.9) vs 3.8 (0.0–7.7); p<0.001] and increased progressively with AKI severity. Each 1-point increase in VIS-max independently increased the odds of AKI (adjusted OR 1.31, 95% CI 1.12–1.54; p<0.001). VIS-max showed good discrimination for AKI (AUC 0.845); a cut-off of 9.5 yielded 66.7% sensitivity and 88.7% specificity. Discrimination was highest after combined CABG and valvular surgery (AUC 0.890).
Early postoperative VIS-max was an independent predictor of AKI after cardiac surgery and may facilitate renal-risk stratification.
Published in Journal of chemical health risks. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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