An updated HACOR score for predicting the failure of noninvasive ventilation: a multicenter prospective observational study

作者：Jun Duan, Lijuan Chen, Xiaoyi Liu, Süha Bozbay, Yuliang Liu, Ke Wang, António M. Esquinas, Weiwei Shu, Fuxun Yang, Dehua He, Qimin Chen, Bilin Wei, Baixu Chen, Liucun Li, Manyun Tang, Guodan Yuan, Fei Ding, Tao Huang, Zhongxing Zhang, ZhiJun Tang, Xiaoli Han, Lei Jiang, Linfu Bai, Wenhui Hu, Rui Zhang, Bushra Mina · 发表于：Critical Care · 年份：2022 · DOI：10.1186/s13054-022-04060-7 · 被引用次数：84 · 研究领域：Respiratory Support and Mechanisms、Nosocomial Infections in ICU、Sepsis Diagnosis and Treatment

BACKGROUND: Heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) have been used to predict noninvasive ventilation (NIV) failure. However, the HACOR score fails to consider baseline data. Here, we aimed to update the HACOR score to take into account baseline data and test its predictive power for NIV failure primarily after 1-2 h of NIV. METHODS: A multicenter prospective observational study was performed in 18 hospitals in China and Turkey. Patients who received NIV because of hypoxemic respiratory failure were enrolled. In Chongqing, China, 1451 patients were enrolled in the training cohort. Outside of Chongqing, another 728 patients were enrolled in the external validation cohort. RESULTS: Before NIV, the presence of pneumonia, cardiogenic pulmonary edema, pulmonary ARDS, immunosuppression, or septic shock and the SOFA score were strongly associated with NIV failure. These six variables as baseline data were added to the original HACOR score. The AUCs for predicting NIV failure were 0.85 (95% CI 0.84-0.87) and 0.78 (0.75-0.81) tested with the updated HACOR score assessed after 1-2 h of NIV in the training and validation cohorts, respectively. A higher AUC was observed when it was tested with the updated HACOR score compared to the original HACOR score in the training cohort (0.85 vs. 0.80, 0.86 vs. 0.81, and 0.85 vs. 0.82 after 1-2, 12, and 24 h of NIV, respectively; all p values < 0.01). Similar results were found in the validation cohort (0.78 v...