{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:37:38Z","timestamp":1769924258681,"version":"3.49.0"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: The vasoactive\u2013inotropic score (VIS) predicts unfavorable outcomes after cardiac surgery in both children and adults. In our adult population, we investigated whether preoperative levels of vitamin D can predict the VIS and whether both vitamin D and the VIS can predict adverse outcomes following major heart surgery. Methods: Between 1 October 2021 and 28 February 2022, 300 patients underwent major cardiac surgery at our institution. Eighty-three of them had their 25-OH vitamin D levels measured before surgery. For this cohort, we calculated the VIS based on doses of vasoactive and inotropic medications administered post-surgery. Utilizing receiver operating curves, the predictive accuracy of vitamin D levels and the VIS in predicting acute kidney injury was assessed. Results: The median age of the cohort was 66 (IQR 61\u201371) years, with 59% being male and a median BMI of 28.4 (IQR 25.2\u201331.6). The most common procedures were aortic valve replacement, mitral valve replacement, coronary artery bypass grafting, aortic valve and ascending aorta repair, and ASD correction. There was a significant difference in the postoperative VIS between patients with vitamin D deficiency, i.e., &lt;20 ng\/mL, and patients with vitamin D values &gt; 20 ng\/mL (3.5 vs. 1.3 p &lt; 0.04). We also found a significant correlation between the VIS and the days of hospitalization (r = 0.335; p = 0.002), the days of stay in the intensive care unit (r = 0.547; p &lt; 0.00001), and the mechanical ventilation time (r = 0.327; p = 0.025). Both vitamin D levels and the VIS predicted postoperative acute kidney injury (p &lt; 0.05). Conclusions: Vitamin D deficiency is correlated with the VIS in adults undergoing major cardiac surgery. Both vitamin D levels and the VIS can predict unfavorable postoperative outcomes.<\/jats:p>","DOI":"10.3390\/life14111349","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T06:11:25Z","timestamp":1729577485000},"page":"1349","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lower Levels of Vitamin D Are Associated with Higher Vasoactive\u2013Inotropic Scores in Major Cardiac Surgery"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5574-3969","authenticated-orcid":false,"given":"Adrian","family":"Stef","sequence":"first","affiliation":[{"name":"Clinical Department of Anesthesia and Intensive Care, Heart Institute \u201cNiculae Stancioiu\u201d, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Motilor 19-21, 400001 Cluj-Napoca, Romania"},{"name":"Anesthesia and Intensive Care 2 Discipline, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Victor Babes Nr 8 Street, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7798-0762","authenticated-orcid":false,"given":"Constantin","family":"Bodolea","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care 2 Discipline, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Victor Babes Nr 8 Street, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona Sorana","family":"Cainap","sequence":"additional","affiliation":[{"name":"Department of Mother and Child, 2nd Pediatric Discipline, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Victor Babes Nr 8 Street, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1288-3918","authenticated-orcid":false,"given":"Monica","family":"Muntean","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Epidemiology Department, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Victor Babes Nr 8 Street, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelia Georgeta","family":"Solomonean","sequence":"additional","affiliation":[{"name":"Clinical Department of Anesthesia and Intensive Care, Heart Institute \u201cNiculae Stancioiu\u201d, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Motilor 19-21, 400001 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadina","family":"Tintiuc","sequence":"additional","affiliation":[{"name":"Clinical Department of Anesthesia and Intensive Care, Heart Institute \u201cNiculae Stancioiu\u201d, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Motilor 19-21, 400001 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Razvan Olimpiu","family":"Mada","sequence":"additional","affiliation":[{"name":"Cardiology Department, Heart Institute \u201cNiculae Stancioiu\u201d, Motilor 19-21, 400001 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7352-9584","authenticated-orcid":false,"given":"Gabriel","family":"Cismaru","sequence":"additional","affiliation":[{"name":"4th Department of Internal Medicine, Cardiology Rehabilitation, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, Victor Babes Nr 8 Street, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1749-8090-6-21","article-title":"A comparative study of four intensive care outcome prediction models in cardiac surgery patients","volume":"6","author":"Doerr","year":"2011","journal-title":"J. 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