Assessment of the vasoactive-inotropic score in prognostic evaluation of critical patients following noncardiac surgery: a retrospective, observational study

To explore the value of the Vasoactive-Inotropic Score (VIS) in evaluating the prognosis of patients admitted to the ICU after noncardiac surgical operations. A retrospective analysis was conducted on 3,365 post-noncardiac surgical patients admitted to the Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, from January 2018 to June 2022. The VIS was calculated based on the maximum and average doses of vasoactive and inotropic agents administered within the first 24 h after noncardiac surgery. Patients were divided into five groups according to VIS levels: 0–5, 6–15, 16–30, 31–45, and > 45 points. The primary outcome was 28-day mortality. The mean 24-h maximum VIS of post-noncardiac surgical ICU patients was 1.2, with over half of the patients having a VIS below 5 points. Mortality in patients with higher VIS was significantly higher than in those with lower VIS, with the mortality rates of the five VIS groups being 7.5%, 9.4%, 12.1%, 17.2%, and 33.8%, respectively. Kaplan–Meier survival curves showed that patients with a VIS > 45 had poorer survival rates. The incidence of infection and sepsis increased with higher VIS. Multivariate logistic regression analysis identified a 24-h maximum VIS > 45 was an independent risk factor for 28-day mortality. VIS yielded an AUC of 0.744 for predicting ICU mortality and 0.683 for predicting 28-day mortality. In short-term prognosis assessment, the predictive value of VIS was better than the Sequential Organ Failure Assessment (SOFA) score and serum lactate level. Adult post-noncardiac surgical ICU patients have a high incidence of infection and poor outcomes. A higher VIS robustly predicts adverse postoperative outcomes, with independent prognostic value in this Chinese cohort. Though not supplanting established tools (e.g., Acute Physiology and Chronic Health Evaluation II [APACHE II], SOFA), VIS serves as a complementary indicator, providing additional real-time hemodynamic insights. Larger prospective studies are needed to verify whether VIS-guided interventions improve patient outcomes.