TY - JOUR
T1 - Maximum vasoactive-inotropic score and mortality in extremely premature, extremely low birth weight infants
AU - Aziz, Khyzer B.
AU - Lavilla, Orlyn C.
AU - Wynn, James L.
AU - Lure, Allison C.
AU - Gipson, Daniel
AU - de la Cruz, Diomel
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Objective: To determine the relationship between maximum vasoactive-inotropic (VISmax) and mortality in extremely premature (<29 weeks completed gestation), extremely low birth weight (ELBW, <1000 g) infants. Study design: Single center, retrospective, and observational cohort study. Results: We identified 436 ELBW, <29 week, inborn infants cared for during the study period. Compared to infants with VISmax of 0, the frequency of mortality based on VISmax ranged from 3.3-fold to 46.1-fold. VISmax > 30 was associated with universal mortality. Multivariable modeling that included gestational age, birth weight, and VISmax revealed significant utility to predict mortality with negative predictive value of 87.0% and positive predictive value of 84.8% [adjusted AUROC: 0.90, (0.86–0.94)] among patients that received vasoactive-inotropic treatment. Conclusion: VISmax is an objective measure of hemodynamic/cardiovascular support that was directly associated with mortality in extremely premature ELBW infants. The VISmax represents an important step towards neonatal precision medicine and risk stratification of extremely premature ELBW infants.
AB - Objective: To determine the relationship between maximum vasoactive-inotropic (VISmax) and mortality in extremely premature (<29 weeks completed gestation), extremely low birth weight (ELBW, <1000 g) infants. Study design: Single center, retrospective, and observational cohort study. Results: We identified 436 ELBW, <29 week, inborn infants cared for during the study period. Compared to infants with VISmax of 0, the frequency of mortality based on VISmax ranged from 3.3-fold to 46.1-fold. VISmax > 30 was associated with universal mortality. Multivariable modeling that included gestational age, birth weight, and VISmax revealed significant utility to predict mortality with negative predictive value of 87.0% and positive predictive value of 84.8% [adjusted AUROC: 0.90, (0.86–0.94)] among patients that received vasoactive-inotropic treatment. Conclusion: VISmax is an objective measure of hemodynamic/cardiovascular support that was directly associated with mortality in extremely premature ELBW infants. The VISmax represents an important step towards neonatal precision medicine and risk stratification of extremely premature ELBW infants.
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U2 - 10.1038/s41372-021-01030-9
DO - 10.1038/s41372-021-01030-9
M3 - Article
C2 - 33712712
AN - SCOPUS:85102497339
SN - 0743-8346
VL - 41
SP - 2337
EP - 2344
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 9
ER -