PDF(Pubmed)
Abstract：
The relationship between VISmax and mortality in patients undergoing major abdominal surgery remains unclear. This study aims to evaluate the association between VISmax and both short-term and long-term all-cause mortality in patients undergoing major abdominal surgery, VISmax was calculated (VISmax = dopamine dose [µg/kg/min] + dobutamine dose [µg/kg/min] + 100 × epinephrine dose [µg/kg/min] + 10 × milrinone dose [µg/kg/min] + 10,000 × vasopressin dose [units/kg/min] + 100 × norepinephrine dose [µg/kg/min]) using the maximum dosing rates of vasoactives and inotropics within the first 24 h postoperative ICU admission. The study included 512 patients first admitted to the intensive care unit (ICU) who were administered vasoactive drugs after major abdominal surgery. The data was extracted from the medical information mart in intensive care-IV database. VISmax was stratified into five categories: 0-5, > 5-15, > 15-30, > 30-45, and > 45. Compared to patients with the lowest VISmax (≤ 5), those with the high VISmax (> 45) had an increased risk of 30-day mortality (hazard ratio [HR] 3.73, 95% CI 1.16-12.02; P = 0.03) and 1-year mortality (HR 2.76, 95% CI 1.09-6.95; P = 0.03) in fully adjusted Cox models. The ROC analysis for VISmax predicting 30-day and 1-year mortality yielded AUC values of 0.69 (95% CI 0.64-0.75) and 0.67 (95% CI 0.62-0.72), respectively. In conclusion, elevated VISmax within the first postoperative 24 h after ICU admission was associated with increased risks of both short-term and long-term mortality in patients undergoing major abdominal surgery.
摘要：
VISmax与腹部大手术患者死亡率之间的关系尚不清楚。本研究旨在评估腹部大手术患者VISmax与短期和长期全因死亡率之间的关系。计算VISmax(VISmax=多巴胺剂量[µg/kg/min]+多巴酚丁胺剂量[µg/kg/min]+100×肾上腺素剂量[µg/kg/min]+10×米力农剂量[µg/kg/min]+10,000×血管加压素剂量[单位/kg/min]+100×去甲肾上腺素[剂量/min/24次术后最大剂量))该研究包括512例首次入住重症监护病房（ICU）的患者，这些患者在腹部大手术后接受了血管活性药物的治疗。数据是从重症监护IV数据库中的医疗信息集市中提取的。将VISmax分为五类:0-5、>5-15、>15-30、>30-45和>45。与最低VISmax（≤5）的患者相比，在完全校正的Cox模型中,高VISmax(>45)患者30日死亡率(风险比[HR]3.73,95%CI1.16~12.02;P=0.03)和1年死亡率(HR2.76,95%CI1.09~6.95;P=0.03)的风险增加.VISmax预测30天和1年死亡率的ROC分析得出的AUC值为0.69（95％CI0.64-0.75）和0.67（95％CI0.62-0.72），分别。总之,在接受大型腹部手术的患者中,入住ICU后24h内的VISmax升高与短期和长期死亡率的风险增加相关.
