HACOR score as a predictor of non-invasive ventilation failure leading to invasive mechanical ventilation and mortality in acute respiratory failure: A prospective study
- Author:
Abegail Marie S. Yangyang
1
;
Merci Angelie Letigio-Uy
1
Author Information
- Publication Type:Journal Article
- Keywords: Acute respiratory failure; HACOR
- MeSH: Noninvasive ventilation
- From: Philippine Journal of Internal Medicine 2025;63(4):42-50
- CountryPhilippines
- Language:English
-
Abstract:
Abstract:A It is critical to identify the parameters that can help predict patients with acute respiratory failure (ARF) who will fail on non-invasive ventilation (NIV), because delayed intubation following NIV failure shows a significant increase in in- hospital mortality. A reliable clinical tool that effectively identifies patients at risk for NIV failure is essential for timely intubation when it is imperative. This study aims to evaluate HACOR score in predicting NIV failure leading to invasive mechanical ventilation and/or mortality among patients with ARF who were admitted to a tertiary hospital in Cebu City from January 2022 to August 2022.
Methods:This prospective, observational, single-center study included adult patients admitted between January 2022 to August 2022 who were diagnosed with ARF type 1 and/or 2 and who were hooked to NIV as oxygen supplementation. Parameters of HACOR were collected and analyzed prior to initiation and 1 hour after hooking to NIV.
Results:Fifty adult patients with type 1 and/or type 2 ARF who required NIV were included. At 1 hour of NIV, the area under the receiver operating characteristic curve for the prediction of NIV failure, intubation, and mortality were 0.86, 0.89, and 0.80, respectively. Cut-off value for HACOR score was >5 with sensitivity in predicting NIV failure, intubation, and mortality, respectively: 78.3%, 82.4%, and 75%; the specificities were 92.6%, 92.9%, and 83.3%, respectively. Positive and negative predictive values were 90% and 83.3%, respectively. The computed overall accuracy was 86% (95% CI, 73.26–94.18).
Conclusion:We found that the HACOR score can be used as a tool to effectively predict NIV failure in patients with ARF, with a higher score indicating a higher chance of NIV failure. Variables in the HACOR score, including a lower Glasgow Coma Scale score and a higher respiratory rate, were shown to be independent factors associated with the need for endotracheal intubation. In these high-risk patients, early intubation may reduce the risk of adverse outcomes. - Full text:20260630152105595438-2024-369.pdf
