Comparison of Inotrope Score as A Predictor Of Mortality in Patients with

Cardiogenic Shock
PRADIPTA Leo Deddy, ALAMSYAPUTRA Adwin1, FARISSA Inne Pratiwi1, SAFIR1
1
Dr. Kariadi Central General Hospital, Semarang, Indonesia

OBJECTIVES
To compare the TIES and VIS in predicting the mortality in patient with cardiogenic shock.
MATERIALS AND METHODS
This study was a-single centre, retrospective study, included 40 patients with cardiogenic
shock between November 2021 – October 2022. We calculated VIS using the total of highest
dose of inotropes and vasopressors administered during the first and subsequent 24 hour
(VISmax24 and VISmax48). We dichotomize VIS into “high” if VIS max24 >20; VISmax48 >15
and into “low” if VISmax24 <20; VISmax48 <15. TIES was calculated by adding time factor for
each individual vasoactive and inotrope drugs. TIES >23.5 was associated with poor
outcome. The data was analysed using IBM SPSS Statistics 26.
RESULTS
Of the 40 patients, 16 patients (40%) died in CVCU. The VIS max24 >20 was found in 8
patients (20%), VISmax48 >15 in 4 patients (10%), and TIES >23.5 in 16 patients (40%).
Diagnostic score test for predicting mortality: VIS max24 obtained 43.75% sensitivity, 95.83%
specificity, positive predictive value (PPV) 87.5%, negative predictive value (NPV) 71.88%
and 75% accuracy; VISmax48 obtained 12.5% sensitivity, 91.67% specificity, PPV 50%, NPV
57.89% and 60% accuracy; and TIES has 87.5% sensitivity, 91.67% specificity, PPV 87.5%,
NPV 91.67% and 90% accuracy. Area under Receiver Operating Characteristic (AuROC) in
VISmax24, VISmax48, and TIES is 0.727, 0.484, and 0.897, respectively.
CONCLUSIONS
The Total Inotrope Exposure Score appears as better score in predicting mortality in patient
with cardiogenic shock and warrants prospective validation in larger numbers of patients
across institutions.
 Table 1. Characteristics of scores as predictors of mortality

Sensitivit Specificit Accurac

Score PPV NPV
y y y
VISmax24 43.75 95.83 75.00 87.50 71.88
VISmax48 12.50 91.67 60.00 50.00 57.89
TIES 87.50 91.67 90.00 87.50 91.67
PPV = positive predictive value; NPV: negative predictive value