Research Article

Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study

Volume: 40 Number: 4 October 26, 2026
Developments and Experiments in Health and Medicine Cover
Developments and Experiments in Health and Medicine
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Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study

Abstract

Objective: Extracorporeal therapies, including continuous renal replacement therapy (CRRT), therapeutic plasma exchange (TPE), and extracorporeal membrane oxygenation (ECMO), are applied in the most critically ill pediatric intensive care unit (PICU) patients. This study aimed to compare the predictive performance of the Pediatric Risk of Mortality (PRISM) score, Pediatric Logistic Organ Dysfunction (PELOD) score, and Vasoactive-Inotropic Score (VIS) for PICU mortality and to identify independent outcome predictors. Methods: A single-center retrospective cohort study included patients aged 1 month–18 years receiving CRRT, TPE, or ECMO at a tertiary PICU (January 2015–December 2020). Survivors and non-survivors were compared using Mann-Whitney U and chi-square tests. Discriminative ability was assessed by ROC curve analysis. Independent predictors were identified by binary logistic regression. Results: A total of 106 patients were enrolled (median age 64 months, 57.5% male); overall mortality was 43.4% (n=46). CRRT was applied in 84.9%, TPE in 30.2%, and ECMO in 5.7%. Non-survivors had significantly higher PRISM, PELOD, and peak VIS (all p<0.001). VIS demonstrated the highest discriminative power (AUC 0.874, 95% CI 0.793–0.956; cut-off >21.25, sensitivity 82.6%, specificity 75.0%, PPV 71.7%, NPV 84.9%), followed by PELOD (AUC 0.849) and PRISM (AUC 0.821). Peak VIS was the sole independent predictor in both models (OR 1.036, 95% CI 1.016–1.056, p<0.001; Nagelkerke R²=0.725 and 0.727). Conclusion: Peak VIS outperformed PRISM and PELOD as an independent mortality predictor in critically ill children receiving extracorporeal organ support. Dynamic monitoring of vasoactive-inotropic burden may provide stronger prognostic information than static admission severity scores.

Keywords

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Project Number

Not applicable (N/A)

Ethical Statement

The study was approved by the İzmir Tepecik Training and Research Hospital Non-Interventional Clinical Research Ethics Committee (Decision No. 2022/04, Date: April 15, 2022). The study was conducted in accordance with the principles of the Declaration of Helsinki. The requirement for informed consent was waived due to the retrospective nature of the study.

Thanks

The authors have no acknowledgements.

References

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Details

Primary Language

English

Subjects

Intensive Care

Journal Section

Research Article

Authors

Publication Date

October 26, 2026

Submission Date

July 31, 2026

Acceptance Date

August 27, 2026

Published in Issue

Year 2026 Volume: 40 Number: 4

DOI

https://doi.org/10.18614/dehm.2007674

IZ

https://izlik.org/JA86PL89BW

Cite

RIS / Bibtex
APA
Durak, F., Küllüoğlu, E. P., Ozcıfcı, G., Sallak, D., & Anıl, A. B. (2026). Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study. Developments and Experiments in Health and Medicine, 40(4), 514-524. https://doi.org/10.18614/dehm.2007674
AMA
1.Durak F, Küllüoğlu EP, Ozcıfcı G, Sallak D, Anıl AB. Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study. Dev Exp Health Med. 2026;40(4):514-524. doi:10.18614/dehm.2007674
Chicago
Durak, Fatih, Emine Pınar Küllüoğlu, Gokcen Ozcıfcı, Damla Sallak, and Ayşe Berna Anıl. 2026. “Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study”. Developments and Experiments in Health and Medicine 40 (4): 514-24. https://doi.org/10.18614/dehm.2007674.
EndNote
Durak F, Küllüoğlu EP, Ozcıfcı G, Sallak D, Anıl AB (October 1, 2026) Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study. Developments and Experiments in Health and Medicine 40 4 514–524.
IEEE
[1]F. Durak, E. P. Küllüoğlu, G. Ozcıfcı, D. Sallak, and A. B. Anıl, “Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study”, Dev Exp Health Med, vol. 40, no. 4, pp. 514–524, Oct. 2026, doi: 10.18614/dehm.2007674.
ISNAD
Durak, Fatih - Küllüoğlu, Emine Pınar - Ozcıfcı, Gokcen - Sallak, Damla - Anıl, Ayşe Berna. “Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study”. Developments and Experiments in Health and Medicine 40/4 (October 1, 2026): 514-524. https://doi.org/10.18614/dehm.2007674.
JAMA
1.Durak F, Küllüoğlu EP, Ozcıfcı G, Sallak D, Anıl AB. Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study. Dev Exp Health Med. 2026;40:514–524.
MLA
Durak, Fatih, et al. “Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study”. Developments and Experiments in Health and Medicine, vol. 40, no. 4, Oct. 2026, pp. 514-2, doi:10.18614/dehm.2007674.
Vancouver
1.Fatih Durak, Emine Pınar Küllüoğlu, Gokcen Ozcıfcı, Damla Sallak, Ayşe Berna Anıl. Prognostic Value of Vasoactive-Inotropic Score in Critically Ill Children Receiving Extracorporeal Organ Support: A Retrospective Cohort Study. Dev Exp Health Med. 2026 Oct. 1;40(4):514-2. doi:10.18614/dehm.2007674