The inotropic score as a predictor of mortality in neonates after complex cardiac surgery

Background Neonates undergoing cardiac surgery are at high risk of postoperative mortality.It is necessary to identify clinical factors that are indicative of in-hospital mortality.The study investigated the predictive value of inotropic score(IS)and vasoactive-inotropic score(VIS)for mortality in neonates after complex cardiac surgery.Methods This was a retrospective analysis of the 214 neonates who underwent complex cardiac surgery for congenital heart disease at a tertiary pediatric cardiac surgery intensive care unit from January 2015 to November 2017.Multiple demographics,intraoperative and postoperative variables were recorded.Multivariate logistic regression and the receiver operating characteristic(ROC)curve were performed to evaluate the relationship between IS/VIS and in-hospital mortality.Results The neonates were divided into two groups according to mortality.Neonates in the non-surviving group(n=16)had higher IS and VIS than those in surviving group(n=198).On multivariable regression analysis,after adjustment for potential confounders,IS but not VIS remained a strong predictor of in-hospital mortality,[initial IS:odds ratio(per 5-score increase):1.68,95%confidence interval:1.16-2.44,P=0.007;maximum IS:odds ratio(per 5-score increase):1.62,95%confidence interval:1.10-2.37,P=0.014].Conclusions In newborns with congenital heart disease,IS but not VIS within 24 hours is helpful for prediction of mortality at the early postoperative period after neonatal complex cardiac surgery.