Observational studyIntensive care medicine2017
Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients.
Observational study in Intensive care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 158 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Non-invasive Ventilation in Covid-19 Respiratory Failure - Predicting Success: A Retrospective Observational Study to Determine Predictive Factors in the Success or Failure of Non-invasive Ventilation.
A Physiological Study of High PEEP During Noninvasive Ventilation in Patients With Hypoxemic Respiratory Failure
Who cites it
158 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- The ROX index as a predictor of high-flow nasal cannula outcome in pneumonia patients with acute hypoxemic respiratory failure: a systematic review and meta-analysis.BMC pulmonary medicine · 2022Pooled it
- High-Flow Nasal Cannula Oxygen Therapy versus Non-Invasive Ventilation for AECOPD Patients After Extubation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.International journal of chronic obstructive pulmonary disease · 2022Pooled it
- [Clinical consensus recommendations regarding non-invasive respiratory support in the adult patient with acute respiratory failure secondary to SARS-CoV-2 infection].Medicina intensiva · 2020Guideline
- Position paper on the preparation of immune plasma to be used in the treatment of patients with COVID-19.Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2020Guideline
- Position paper on the preparation of immune plasma to be used in the treatment of patients with COVID-19.Blood transfusion = Trasfusione del sangue · 2020Guideline
- Position Paper for the State-of-the-Art Application of Respiratory Support in Patients with COVID-19.Respiration; international review of thoracic diseases · 2020Guideline
- Update of the recommendations of the Sociedade Portuguesa de Cuidados Intensivos and the Infection and Sepsis Group for the approach to COVID-19 in Intensive Care Medicine.Revista Brasileira de terapia intensivaPooled it
- Low versus high positive end expiratory pressure in noninvasive ventilation for hypoxemic respiratory failure: a multicenter randomized controlled trial.Intensive care medicine · 2025Trial
- A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome.Critical care (London, England) · 2019Trial
- Comparison of HACOR score and ROX index for predicting noninvasive ventilation failure in acute hypoxemic respiratory failure: a prospective study.Irish journal of medical science · 2026Article
- Predictive Accuracy of the 1-h HACOR Score for Identifying Non-Invasive Ventilation Failure in COPD Patients With Acute Hypercapnic Respiratory Failure: A Prospective Observational Study.Health science reports · 2026Article
- Comparison of standardized diaphragm ultrasound measurement and conventional methods for predicting weaning failure: a prospective observational study.Journal of anesthesia · 2026Observational
- ARDS management in trauma patients.Intensive care medicine · 2026Review
- Predicting Failure at Initiation of High-Flow Nasal Oxygen in Patients With COVID-19: Literature Review, Development and Internal Validation of a Prediction Model.Respirology (Carlton, Vic.) · 2026Observational
- Review
- Integrating validated scores with clinical parameters to predict NIV weaning outcomes: a prospective study in the respiratory ICU.Scientific reports · 2026Observational
- Time-dependent predictive value of the HACOR score for non-invasive ventilation failure in the emergency department: a prospective cohort study.BMC emergency medicine · 2026Observational
- [Invasive mechanical ventilation: indications and alternatives : Systematic evaluation of the evidence and recommendations for clinical practice from the S3 guidelines "invasive mechanical ventilation and the use of extracorporeal procedures in acute respiratory failure"].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- Identification of physiological clusters in acute hypoxemic respiratory failure patients undergoing non-invasive respiratory support using EIT-based t-SNE and spectral clustering.Intensive care medicine experimental · 2026Article
- Development of an Artificial Intelligence Model to Predict Endotracheal Intubation in Critically Ill Patients in Real Time.Journal of clinical medicine · 2026Article
98 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo develop and validate a scale using variables easily obtained at the bedside for prediction of failure of noninvasive ventilation (NIV) in hypoxemic patients.
methodsThe test cohort comprised 449 patients with hypoxemia who were receiving NIV. This cohort was used to develop a scale that considers heart rate, acidosis, consciousness, oxygenation, and respiratory rate (referred to as the HACOR scale) to predict NIV failure, defined as need for intubation after NIV intervention. The highest possible score was 25 points. To validate the scale, a separate group of 358 hypoxemic patients were enrolled in the validation cohort.
resultsThe failure rate of NIV was 47.8 and 39.4% in the test and validation cohorts, respectively. In the test cohort, patients with NIV failure had higher HACOR scores at initiation and after 1, 12, 24, and 48 h of NIV than those with successful NIV. At 1 h of NIV the area under the receiver operating characteristic curve was 0.88, showing good predictive power for NIV failure. Using 5 points as the cutoff value, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for NIV failure were 72.6, 90.2, 87.2, 78.1, and 81.8%, respectively. These results were confirmed in the validation cohort. Moreover, the diagnostic accuracy for NIV failure exceeded 80% in subgroups classified by diagnosis, age, or disease severity and also at 1, 12, 24, and 48 h of NIV. Among patients with NIV failure with a HACOR score of >5 at 1 h of NIV, hospital mortality was lower in those who received intubation at ≤12 h of NIV than in those intubated later [58/88 (66%) vs. 138/175 (79%); p = 0.03).
conclusionsThe HACOR scale variables are easily obtained at the bedside. The scale appears to be an effective way of predicting NIV failure in hypoxemic patients. Early intubation in high-risk patients may reduce hospital mortality.
Indexed as
Identifiers
27812731What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.