Snigdha Bellapukonda, Basanth K Rayani, Vibhavari Naik
{"title":"预测癌症手术患者术后并发症的血管活性肌力评分--一项前瞻性观察研究。","authors":"Snigdha Bellapukonda, Basanth K Rayani, Vibhavari Naik","doi":"10.1007/s13193-024-02004-x","DOIUrl":null,"url":null,"abstract":"<p><p>In this study, we evaluated Vasoactive Inotrope score (VIS) for prognosis in onco-surgery patients and determine whether there is correlation between VIS and grade of complication (according to Modified Clavien-Dindo Classification). This prospective observational study was conducted at Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India. The setting conducted at a tertiary care referral centre. The participants aged 18-65 years, undergoing major abdominopelvic and thoracic onco-surgeries, requiring vasopressor and ionotropic support in an intensive care unit from May 2022 to February 2023, were recruited into the study. Thus, 257 patients were enrolled. Patients were given noradrenaline, adrenaline, vasopressin, dopamine, and dobutamine. Patients, on other vasopressor infusions, who lost to follow-up and are not willing to participate in the study were excluded. The following are the main outcome(s) and measure(s): Initial Vasoactive Inotrope score (VIS<sub>0</sub>), maximum Vasoactive Inotrope score (VIS<sub>max</sub>), and grade of complication. VIS<sub>max</sub> has significant positive correlation (<i>r</i> = 0.147; <i>p</i> = 0.01) with grade of complication. Both VIS<sub>0</sub> and VIS<sub>max</sub> have a significant positive correlation with length of ICU stay (<i>r</i> = 0.164, <i>p</i> = 0.001; <i>r</i> = 0.242, <i>p</i> = 0.001). Also there is a significant Odds Ratio (OR = 1.068; 95% CI = 1.004-1.136; <i>p</i> = 0.036) of patient having ≥ Grade 3 complication if VIS<sub>max</sub> increases by a unit. A cutoff of VIS<sub>max</sub> > 5.1 had a sensitivity of 82.1% and specificity of 33.5% (<i>p</i> = 0.014) to predict ≥ Grade 3 complications. VIS<sub>max</sub> may be helpful in predicting higher grade of complication and length of ICU stay in onco-surgery patients. This study is the very first one to evaluate VIS in cancer patients; further studies would help in strengthening the findings. Trial Registration: CTRI/2022/09/045237; www.ctri.nic.in.</p>","PeriodicalId":46707,"journal":{"name":"Indian Journal of Surgical Oncology","volume":"15 4","pages":"844-848"},"PeriodicalIF":0.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11564479/pdf/","citationCount":"0","resultStr":"{\"title\":\"Vasoactive Inotrope Score as a Predictor of Postoperative Complications in Cancer Surgery Patients-A Prospective Observational Study.\",\"authors\":\"Snigdha Bellapukonda, Basanth K Rayani, Vibhavari Naik\",\"doi\":\"10.1007/s13193-024-02004-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>In this study, we evaluated Vasoactive Inotrope score (VIS) for prognosis in onco-surgery patients and determine whether there is correlation between VIS and grade of complication (according to Modified Clavien-Dindo Classification). This prospective observational study was conducted at Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India. The setting conducted at a tertiary care referral centre. The participants aged 18-65 years, undergoing major abdominopelvic and thoracic onco-surgeries, requiring vasopressor and ionotropic support in an intensive care unit from May 2022 to February 2023, were recruited into the study. Thus, 257 patients were enrolled. Patients were given noradrenaline, adrenaline, vasopressin, dopamine, and dobutamine. Patients, on other vasopressor infusions, who lost to follow-up and are not willing to participate in the study were excluded. The following are the main outcome(s) and measure(s): Initial Vasoactive Inotrope score (VIS<sub>0</sub>), maximum Vasoactive Inotrope score (VIS<sub>max</sub>), and grade of complication. VIS<sub>max</sub> has significant positive correlation (<i>r</i> = 0.147; <i>p</i> = 0.01) with grade of complication. Both VIS<sub>0</sub> and VIS<sub>max</sub> have a significant positive correlation with length of ICU stay (<i>r</i> = 0.164, <i>p</i> = 0.001; <i>r</i> = 0.242, <i>p</i> = 0.001). Also there is a significant Odds Ratio (OR = 1.068; 95% CI = 1.004-1.136; <i>p</i> = 0.036) of patient having ≥ Grade 3 complication if VIS<sub>max</sub> increases by a unit. A cutoff of VIS<sub>max</sub> > 5.1 had a sensitivity of 82.1% and specificity of 33.5% (<i>p</i> = 0.014) to predict ≥ Grade 3 complications. VIS<sub>max</sub> may be helpful in predicting higher grade of complication and length of ICU stay in onco-surgery patients. This study is the very first one to evaluate VIS in cancer patients; further studies would help in strengthening the findings. 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引用次数: 0
摘要
在这项研究中,我们对肿瘤手术患者的预后进行了血管活性肌力评分(VIS)评估,并确定 VIS 与并发症等级(根据改良克拉维恩-丁多分类法)之间是否存在相关性。这项前瞻性观察研究在印度海得拉巴的巴萨瓦塔拉卡姆印美癌症医院和研究所(Basavatarakam Indo-American Cancer Hospital and Research Institute)进行。研究地点位于一家三级医疗转诊中心。研究招募了年龄在 18-65 岁之间、在 2022 年 5 月至 2023 年 2 月期间在重症监护病房接受腹盆腔和胸部大型肿瘤手术、需要血管加压和离子支持的患者。因此,共有 257 名患者被纳入研究。患者接受了去甲肾上腺素、肾上腺素、血管加压素、多巴胺和多巴酚丁胺治疗。使用其他血管加压素的患者、失去随访的患者和不愿意参加研究的患者均被排除在外。以下是主要结果和衡量标准:初始血管活性肌力素评分(VIS0)、最大血管活性肌力素评分(VISmax)和并发症等级。VISmax 与并发症等级呈显著正相关(r = 0.147; p = 0.01)。VIS0 和 VISmax 与重症监护室住院时间呈显著正相关(r = 0.164,p = 0.001;r = 0.242,p = 0.001)。此外,如果 VISmax 增加一个单位,患者出现≥ 3 级并发症的几率比(OR = 1.068;95% CI = 1.004-1.136;P = 0.036)也很明显。VISmax > 5.1 的临界值预测≥ 3 级并发症的灵敏度为 82.1%,特异度为 33.5%(p = 0.014)。VISmax 可能有助于预测并发症的等级和住院时间。本研究是首次对癌症患者的 VIS 进行评估,进一步的研究将有助于加强研究结果。试验注册:CTRI/2022/09/045237; www.ctri.nic.in.
Vasoactive Inotrope Score as a Predictor of Postoperative Complications in Cancer Surgery Patients-A Prospective Observational Study.
In this study, we evaluated Vasoactive Inotrope score (VIS) for prognosis in onco-surgery patients and determine whether there is correlation between VIS and grade of complication (according to Modified Clavien-Dindo Classification). This prospective observational study was conducted at Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, India. The setting conducted at a tertiary care referral centre. The participants aged 18-65 years, undergoing major abdominopelvic and thoracic onco-surgeries, requiring vasopressor and ionotropic support in an intensive care unit from May 2022 to February 2023, were recruited into the study. Thus, 257 patients were enrolled. Patients were given noradrenaline, adrenaline, vasopressin, dopamine, and dobutamine. Patients, on other vasopressor infusions, who lost to follow-up and are not willing to participate in the study were excluded. The following are the main outcome(s) and measure(s): Initial Vasoactive Inotrope score (VIS0), maximum Vasoactive Inotrope score (VISmax), and grade of complication. VISmax has significant positive correlation (r = 0.147; p = 0.01) with grade of complication. Both VIS0 and VISmax have a significant positive correlation with length of ICU stay (r = 0.164, p = 0.001; r = 0.242, p = 0.001). Also there is a significant Odds Ratio (OR = 1.068; 95% CI = 1.004-1.136; p = 0.036) of patient having ≥ Grade 3 complication if VISmax increases by a unit. A cutoff of VISmax > 5.1 had a sensitivity of 82.1% and specificity of 33.5% (p = 0.014) to predict ≥ Grade 3 complications. VISmax may be helpful in predicting higher grade of complication and length of ICU stay in onco-surgery patients. This study is the very first one to evaluate VIS in cancer patients; further studies would help in strengthening the findings. Trial Registration: CTRI/2022/09/045237; www.ctri.nic.in.
期刊介绍:
The Indian Journal of Surgical Oncology aims to encourage and promote clinical and research activities pertaining to Surgical Oncology. It also aims to bring in the concept of multidisciplinary team approach in management of various cancers.
The Journal would publish original article, point of technique, review article, case report, letter to editor, profiles of eminent teachers, surgeons and instititions - a short (up to 500 words) of the Cancer Institutions, departments, and oncologist, who founded new departments.