Vasoactive Inotrope Score as a Predictor of Postoperative Complications in Cancer Surgery Patients-A Prospective Observational Study

Snigdha Bellapukonda; Basanth K Rayani; Vibhavari Naik

doi:10.1007/s13193-024-02004-x

Vasoactive Inotrope Score as a Predictor of Postoperative Complications in Cancer Surgery Patients-A Prospective Observational Study

Indian J Surg Oncol. 2024 Dec;15(4):844-848. doi: 10.1007/s13193-024-02004-x. Epub 2024 Jun 29.

Authors

Snigdha Bellapukonda^{1

2}, Basanth K Rayani¹, Vibhavari Naik¹

Affiliations

¹ Department of Onco-Anaesthesia, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, 500034 India.
² Present Address: Department of Anesthesiology, Kamineni Academy of Medical Sciences and Research Centre, L. B. Nagar, Telangana, 500068 India.

PMID: 39555345
PMCID: PMC11564479 (available on 2025-12-01)
DOI: 10.1007/s13193-024-02004-x

Abstract

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 (VIS_max), and grade of complication. VIS_max has significant positive correlation (r = 0.147; p = 0.01) with grade of complication. Both VIS₀ and VIS_max 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 VIS_max increases by a unit. A cutoff of VIS_max > 5.1 had a sensitivity of 82.1% and specificity of 33.5% (p = 0.014) to predict ≥ Grade 3 complications. VIS_max 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.

Keywords: Modified Clavien–Dindo Classification; Onco-surgeries; Post-operative complications; Vasoactive Inotrope score.

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