Chauhan Shilpi, Batra Prerna, Bhaskar Vikram, Gupta Piyush
Department of Pediatrics, University College of Medical Sciences and Guru Tegh Bahadur Hospital, Dilshad Garden, Delhi, 110095, India.
Indian Pediatr. 2025 Apr 25. doi: 10.1007/s13312-025-00076-8.
To determine the area under curve (AUC) for vasoactive ventilation renal score (VVRS) > 10 at 24-h of admission for predicting mortality in children aged 1-12 years admitted to pediatric intensive care unit (PICU). To also determine the AUC for VVRS > 10 at 48-h of admission for predicting mortality and to determine the AUC of VVRS > 10 at 24-h and 48-h of admission for predicting PICU stay > 3 days, hospital stay > 10 days and mechanical ventilation > 3 days.
This observational study included 310 children aged 1-12 years admitted in PICU. All required parameters were noted, and VVRS, ventilation index and change in creatinine at 24-h and 48-h of admission were recoded. Receiver operating characteristic curves were computed to determine the predictive role of VVRS > 10 at 24-h and 48-h for mortality, duration of PICU stay, hospital stay and mechanical ventilation.
Seventy nine (25%) patients succumbed during the study. VVRS > 10 at 24-h and 48-h had a good predictive role for mortality with AUC of 0.873 (sensitivity 89.87%, specificity 69.70%) and 0.996 (sensitivity 96.20%, specificity 96.10%), respectively. Best cutoffs derived for VVRS (24-h), and VVRS (48-h) were > 2.5 and > 13.5. A higher AUC, sensitivity and specificity of VVRS at 48-h were observed for predicting prolonged PICU stay, duration of mechanical ventilation and hospital stay.
VVRS at 24-h and 48-h has a good predictive role for mortality in children admitted to PICU.
确定1 - 12岁入住儿科重症监护病房（PICU）的儿童入院24小时时血管活性通气肾评分（VVRS）>10的曲线下面积（AUC），以预测死亡率。还要确定入院48小时时VVRS>10的AUC以预测死亡率，并确定入院24小时和48小时时VVRS>10的AUC，以预测PICU住院时间>3天、住院时间>10天和机械通气时间>3天。
这项观察性研究纳入了310名1 - 12岁入住PICU的儿童。记录所有所需参数，并记录入院24小时和48小时时的VVRS、通气指数和肌酐变化。计算受试者工作特征曲线，以确定入院24小时和48小时时VVRS>10对死亡率、PICU住院时间、住院时间和机械通气的预测作用。
79名（25%）患者在研究期间死亡。入院24小时和48小时时VVRS>10对死亡率具有良好的预测作用，AUC分别为0.873（敏感性89.87%，特异性69.70%）和0.996（敏感性96.20%，特异性96.10%）。VVRS（24小时）和VVRS（48小时）的最佳截断值分别>2.5和>13.5。观察到入院48小时时VVRS在预测PICU住院时间延长、机械通气时间和住院时间方面具有更高的AUC、敏感性和特异性。
入院24小时和48小时时的VVRS对入住PICU的儿童死亡率具有良好的预测作用。
