SỐC NHIỄM KHUẨN KHÁNG TRỊ THEO ĐIỂM VIS: ĐẶC ĐIỂM VÀ MỐI LIÊN QUAN VỚI KẾT CỤC LÂM SÀNG

Abstract

Introduction: The Vasoactive-Inotropic Score (VIS) has not been investigated as a potential alternative to norepinephrine dose thresholds in defining refractory septic shock. Objective: To examine the clinical characteristics and outcomes of patients with refractory septic shock defined by the VIS score. Methods: A prospective observational study was conducted on 151 patients with septic shock admitted to the Intensive Care Unit of Hoan My Cuu Long Hospital from January 2023 to December 2024. Results: The prevalence of refractory septic shock defined by a VIS score >50 was 31.1%. Baseline clinical and laboratory characteristics were similar between groups. However, the rates of renal replacement therapy (48.9% vs. 13.5%), mechanical ventilation (83.0% vs. 29.8%), and 30-day mortality (72.3% vs. 26.9%) were significantly higher in the refractory shock group (p < 0.001). In multivariable Cox regression analysis, refractory septic shock was associated with an increased risk of 30-day mortality (HR = 3.19; 95% CI: 1.82–5.59), and a higher VIS score was also associated with increased mortality risk (HR = 1.01; 95% CI: 1.00–1.01). Conclusion: Patients with refractory septic shock defined by a VIS score >50 had more severe illness and worse clinical outcomes compared to those without refractory shock. The VIS score was independently associated with an increased risk of 30-day mortality in patients with septic shock.