背景:本研究的目的是进行系统评价和荟萃分析,以检查血管活性-肌力评分(VIS)与手术患者预后之间的关系。
方法:两名独立的审阅者搜索了PubMed,WebofScience,EMBASE,Scopus,科克伦图书馆,谷歌学者,和CNKI数据库从2010年11月开始,当VIS首次发布时,到2022年12月。通过手动搜索纳入研究的参考列表确定了其他研究。合格的研究是那些以英文发表的评估VIS与儿童和成人手术患者的短期或长期患者预后之间的关联的研究。使用RevManManager5.3版进行荟萃分析,质量评估遵循JoannaBriggs研究所(JBI)关键评估清单。
结果:共有58项研究包括29,920名患者,其中34人符合荟萃分析的条件。发现术后早期VIS与长时间机械通气相关(OR5.20,95%CI3.78-7.16),死亡率(OR1.08,95%CI1.05-1.12),急性肾损伤(AKI)(OR1.26,95%CI1.13-1.41),不良结果(OR1.02,95%CI1.01-1.04),和ICU住院时间(LOS)(OR3.50,95%CI2.25-5.44)。VIS作为结果预测因子的最佳临界值在研究之间有所不同,范围从10到30。
结论:术后早期VIS升高与各种不良结局相关,包括急性肾损伤(AKI),机械通气持续时间,死亡率,糟糕的结果,和ICU住院时间(LOS)。在返回重症监护病房(ICU)时监测VIS可以帮助医疗团队进行风险分层。有针对性的干预措施,和家长咨询。
背景:PROSPEROCRD42022359100.
The objective of this study is to conduct a systematic review and meta-analysis examining the relationship between the vasoactive-inotropic score (VIS) and patient outcomes in surgical settings.
Two independent reviewers searched PubMed, Web of Science, EMBASE, Scopus, Cochrane Library, Google Scholar, and CNKI databases from November 2010, when the VIS was first published, to December 2022. Additional studies were identified through hand-searching the reference lists of included studies. Eligible studies were those published in English that evaluated the association between the VIS and short- or long-term patient outcomes in both pediatric and adult surgical patients. Meta-analysis was performed using RevMan Manager version 5.3, and quality assessment followed the Joanna Briggs Institute (JBI) Critical Appraisal Checklists.
A total of 58 studies comprising 29,920 patients were included in the systematic review, 34 of which were eligible for meta-analysis. Early postoperative VIS was found to be associated with prolonged mechanical ventilation (OR 5.20, 95% CI 3.78-7.16), mortality (OR 1.08, 95% CI 1.05-1.12), acute kidney injury (AKI) (OR 1.26, 95% CI 1.13-1.41), poor outcomes (OR 1.02, 95% CI 1.01-1.04), and length of stay (LOS) in the ICU (OR 3.50, 95% CI 2.25-5.44). The optimal cutoff value for the VIS as an outcome predictor varied between studies, ranging from 10 to 30.
Elevated early postoperative VIS is associated with various adverse outcomes, including acute kidney injury (AKI), mechanical ventilation duration, mortality, poor outcomes, and length of stay (LOS) in the ICU. Monitoring the VIS upon return to the Intensive Care Unit (ICU) could assist medical teams in risk stratification, targeted interventions, and parent counseling.
PROSPERO CRD42022359100.