Association Between Vasoactive Inotropic Score and In-hospital Mortality in Preterm Neonates at <34 Weeks Gestation with Early Pulmonary Hypertension: A Single-center Retrospective Study

Introduction: The relationship between vasoactive-inotropic score (VIS) and in-hospital mortality in Preterm Neonates at <34 Weeks Gestation with Early Pulmonary Hypertension remains unclear. We aimed to clarify this relationship in preterm neonates born at <34 weeks of gestation with early pulmonary hypertension. Methods: A retrospective study was conducted on preterm infants (gestational age <34 weeks) with neonatal pulmonary hypertension who were hospitalized in the Department of Neonatology at Guangdong Women and Children's Hospital between January 2021 and September 2024. Multivariable logistic regression, restricted cubic spline, and subgroup analyzes were employed, adjusting for potential confounders. Results: A total of 238 preterm infants with early pulmonary hypertension at <34 weeks of gestation were included. After adjusting for potential confounding factors, compared with individuals in the lowest VISmax group (VISmax<30), the adjusted odds ratio (OR) for in-hospital mortality was 2.93 (95% CI: 0.9-9.49, p =0.074) in the second group (30≤VISmax<48) and 13.32 (95% CI: 4.64-38.2, p < 0.001) in the third group (48≤VISmax). Furthermore, a linear relationship was observed between VISmax and in-hospital mortality (p = 0.431), with subgroup and sensitivity analyzes confirming the stability of the results. The subgroup analysis did not reveal any significant interaction between VISmax and in-hospital mortality. Conclusion The findings of this retrospective cohort study suggest that VISmax is positively associated with mortality rate in preterm infants with early pulmonary hypertension at <34 weeks.