CO28 | Reliability and validity in predicting adverse outcomes of venous excess ultrasound score: a systematic review

N. Parenti¹, A.O. Rizza², L. Miracapillo², I. Ironico², I. Ardillo² | ¹Medicina Interna Ospedale Maggiore, Bologna, ²Alma Mater Università, Bologna, Italy

Premises and Purpose of the study: The Venous Excess Ultrasound Score (Vexus) has been proposed to evaluate systremic congestion. This review aims to check reliability and validity in predicting adverse outcomes of Vexus score.
Materials and Methods: This review, based on the PRISMA guideline, explored the PubMed, Web of Science, and Scopus databases. Inclusion criteria: studies on the reliability; accuracy in predicting death, re-admission of the Vexus. Three researchers selected studies and then assessed their quality using the QUADAS-2 guidelines. The key words for search were: point of care ultrasound and venous congestion.
Results: We collected 65 studies, 8 studies were included for the final analysis. We have not found studies on Vexus’s reability. In two studies Vexus seems to predict AKI (Hazard ratio=2.8, Odds ratio= 0.5) but in one it does not predict AKI (OR=0.4). One report suggested that Vexus does not predict 28 day mortality (OR=0-75,p=0.6) but one found that Vexus is valid in predicting death heart failure related (AUC=0.89). The score does not seem to predict re-admission but predicts high Central Venous Pressure, CVP (AUC=0.9); it correlates with CVP (r=0.68, p<0.001). The studies collected showed a moderate quality according to QUADAS-2 guidelines.
Conclusions: We found divergent conclusions on the Vexus’s validity in predicting death and AKI. No data on its reliability and few data on re-admission. Further research is needed before using the Vexus score.