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The present study involved determining the availability and threshold of the vasoactive-inotropic score (VIS) for predicting EEx in adults after elective rheumatic heart valve surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The present study was designed as a single-center retrospective cohort study which was conducted with adults who underwent elective rheumatic heart valve surgery with CPB. The highest VIS in the immediate postoperative period was used in the present study. The primary outcome, the availability of VIS for EEx prediction and the optimal threshold value were determined using ROC curve analysis. The gray zone analysis of the VIS was performed by setting the false negative or positive rate\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.05, and the perioperative risk factors for prolonged EEx were identified by multivariate logistic analysis. The postoperative complications and outcomes were compared between different VIS groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 409 patients initially screened, 379 patients were ultimately included in the study. The incidence of EEx was determined to be 112\/379 (29.6%). The VIS had a good predictive value for EEx (AUC\u2009=\u20090.864, 95% CI: [0.828, 0.900],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The optimal VIS threshold for EEx prediction was 16.5, with a sensitivity of 71.54% (65.85\u201376.61%) and a specificity of 88.39% (81.15\u201393.09%). The upper and lower limits of the gray zone for the VIS were determined as (12, 17.2). The multivariate logistic analysis identified age (OR, 1.060; 95% CI: 1.017\u20131.106;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006), EF% (OR, 0.798; 95% CI: 0.742\u20130.859;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), GFR (OR, 0.933; 95% CI: 0.906\u20130.961;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), multiple valves surgery (OR, 4.587; 95% CI: 1.398\u201315.056;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.012), and VIS\u2009&gt;\u200916.5 (OR, 12.331; 95% CI: 5.015\u201330.318;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) as the independent risk factors for the prolongation of EEx. The VIS\u2009\u2264\u200916.5 group presented a greater success rate for EEx, a shorter invasive ventilation support duration, and a lower incidence of complications than did the VIS\u2009&gt;\u200916.5 group, while the incidence of reintubation was similar between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In adults, after elective rheumatic heart valve surgery, the highest VIS in the immediate postoperative period was a good predictive value for EEx, with a threshold of 16.5.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-024-02489-7","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T02:02:08Z","timestamp":1710727328000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Availability and threshold of the vasoactive-inotropic score for predicting early extubation in adults after rheumatic heart valve surgery: a single-center retrospective cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"Yang","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanlei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizheng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyan","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"San","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"issue":"8","key":"2489_CR1","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1056\/NEJMoa1603693","volume":"377","author":"DA Watkins","year":"2017","unstructured":"Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, Forouzanfar MH, Longenecker CT, Mayosi BM, Mensah GA, et al. 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The study procedure was approved by the Medical Ethics Committee of the Affiliated Hospital of North Sichuan Medical College. The study is registered with the Chinese Registry of Clinical Trials (\n                      \n                      ) (ChiCTR2300071659; 22\/05\/2023) and conducted in accordance with the Declaration of Helsinki (2013). The requirement for obtaining written informed consent from each participant was exempted from the Medical Ethics Committee of the Affiliated Hospital of North Sichuan Medical College due to the retrospective nature of the study that ensured no exposure risks to the patients due to any additional intervention.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"102"}}