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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. General Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1415769

Prognostic evaluation of norepinephrine equivalent score and vasoactive-inotropic score in patients with sepsis and septic shock: a retrospective cohort study

Provisionally accepted
Li Wenzhe Li Wenzhe 1Wang Yi Wang Yi 1Buzukela Abuduaini Buzukela Abuduaini 1Li Xiang Li Xiang 1Pan Pengfei Pan Pengfei 2Cui Jian Cui Jian 1YU Xiangyou YU Xiangyou 1*
  • 1 First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
  • 2 Chongqing Three Gorges Central Hospital, Chongqing, China

The final, formatted version of the article will be published soon.

    Background: This study investigated the association between vasoactive medication exposure and mortality risk in patients with sepsis using the norepinephrine equivalent score (NEE) and vasoactive-inotropic score (VIS).Methods: This retrospective cohort study included adult patients with sepsis requiring vasoactive agents. The data were extracted from the MIMIC-IV database. The primary outcome was the 28day mortality. Multivariate Cox regression was used to elucidate the relationship between vasoactive medication exposure and 28-day mortality, as quantified by VIS and NEE. Hazard ratios (HR) with 95% confidence intervals (CI) for 28-day mortality were generated, and forest charts were generated to present the results of univariate and multivariate analyses. The Kaplan-Meier method was used to analyze the cumulative incidence of the 28-day mortality. A nomogram was constructed to predict the prognosis of patients with sepsis.The present study encompassed 9032 patients diagnosed with sepsis who received vasoactive therapy, of which 4229 patients were further analyzed at the second hour after the onset of sepsis. Distinct variations in demographic data were observed between survivors (n = 3265, 77.21%) and non-survivors (n = 964, 22.79%). Multivariate analysis indicated that several factors, including VIS > 15.04 (p = 0.001), NEE > 0.10 (p <0.001), heart rate (p = 0.045), mean arterial pressure (p = 0.009), respiratory rate (p <0.001), oxygen saturation (p <0.001), blood urea nitrogen (BUN) (p = 0.001) and Acute Physiology and Chronic Health Evaluation II (p <0.001) were significantly associated with 28-day mortality in the patients with sepsis. The NEE score, respiratory rate, SpO2, and BUN were incorporated into the nomogram model with a concordance index of 0.779 and an AUC of 0.802 (95% CI 0.787-0.818).We found that both VIS and NEE had favorable values for predicting mortality risk in patients with sepsis in the intensive care units. VIS and NEE in the second hour after sepsis onset were independently associated with 28-day mortality in patients with sepsis.

    Keywords: sepsis1, vasoactive agents2, vasoactive-inotropic score3, norepinephrine equivalence score4, 28-day mortality5

    Received: 15 Apr 2024; Accepted: 12 Jul 2024.

    Copyright: © 2024 Wenzhe, Yi, Abuduaini, Xiang, Pengfei, Jian and Xiangyou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: YU Xiangyou, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

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