Author(s):
Carrillo, A ; Lopez, A ; Carrillo, L ; Caldeira, V ; Guia, M ; Alonso, N ; Renedo, A ; Quintana, M ; Sanchez, J ; Esquinas, A
Date: 2020
Persistent ID: http://hdl.handle.net/10400.17/4647
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): HSM PNEU; Humans; Aged; Male; Female; Middle Aged; Aged, 80 and over; Area Under Curve; Glasgow Coma Scale*; Hospital Mortality; Intensive Care Units; Noninvasive Ventilation / mortality*; Pneumonia / therapy*; Prognosis; Prospective Studies; Respiratory Distress Syndrome / therapy*; Respiratory Insufficiency / therapy*; Retrospective Studies; Time Factors; Vital Signs*
Description
Introduction: The HACOR scale is a clinical score that can predict early failure of NIV in hypoxemic acute respiratory failure (ARF) The aim of this study is to analyze the validity of the HACOR scale. Methods: A retrospective study of a cohort of over 2749 episodes on 2711 consecutive patients requiring NIV for hypoxemic ARF in a polyvalent intensive care unit. The scale was measured before starting NIV and at 1, 6, 12, 24 and 48 h after the initiation of NIV. Results: NIV failure occurred in 963 patients (35%). The value of the HACOR scale before NIV did not differ between success and failure. However, at 1, 6, 12, 24 and 48 h of NIV, the scale values clearly differed between the two groups. The HACOR scale at NIV initiation accurately predicts NIV failure in the first hour, with an optimal cut-off value of 8 points. The AUC for predicting NIV failure with HACOR at 1 h is greater than 0.9 in patients with pneumonia and adult respiratory distress syndrome (ARDS). Conclusions: The HACOR scale measured at 1 h after NIV initiation accurately predicts NIV failure, especially in pneumonia and ARDS.
