SynthesisRespiratory research2022
The value of ROX index in predicting the outcome of high flow nasal cannula: a systematic review and meta-analysis.
Synthesis in Respiratory research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 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.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Pooled it
- Performance of the ROX index in predicting high flow nasal cannula failure in COVID-19 patients: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Prediction of high-flow nasal cannula failure in patients with sepsis by a preliminary risk stratification model based on the ROX index.BMC infectious diseases · 2026Article
- Review
- Prognostic significance of the ROX index in patients with acute exacerbation of interstitial lung disease treated with high-flow nasal cannula oxygen therapy: a retrospective cohort study.BMC pulmonary medicine · 2026Article
- Predicting failure of extubation and non-invasive respiratory support in critically ill patients: clinical complexity, limitations of traditional indices, and machine learning perspectives.Frontiers in medicine · 2026Review
- Patterns and outcomes of real-world high-flow nasal cannula use: a multi-hospital retrospective cohort study.Critical care science · 2026Observational
- Real-time prediction of HFNC treatment failure in acute hypoxemic respiratory failure using machine learning.Scientific reports · 2025Article
- Comparisons of mortality predictions of mROX, CURB-65, and APACHE II in patients with severe pneumonia: A retrospective cohort study.Medicine · 2025Article
- Infants with bronchiolitis with high-flow nasal cannula in the paediatric ward. Is there a role for the ROXi (respiratory rate-oxygenation index) in predicting failure of high-flow nasal cannula?European journal of pediatrics · 2025Observational
- Comparison of ROX index with modified indices incorporating heart rate, flow rate, and PaOEuropean journal of medical research · 2025Article
- Tailored Predictive Indicators for Weaning Success from High-Flow Nasal Cannula in Postoperative Hypoxemic Patients.Life (Basel, Switzerland) · 2025Article
- Association of the ROX index with mortality in sepsis patients: a retrospective study.Frontiers in medicine · 2025Article
- Respiratory Rate Oxygenation (ROX) index as predictor of high flow nasal cannula in pediatric patients in pediatric intensive care unit.BMC pulmonary medicine · 2024Article
- Racial Differences in Accuracy of Predictive Models for High-Flow Nasal Cannula Failure in COVID-19.Critical care explorations · 2024Article
- The respiratory oxygenation index for identifying the risk of orotracheal intubation in COVID-19 patients receiving high-flow nasal cannula oxygen.Critical care science · 2024Observational
- Article
- Helmet Ventilation in a Child with COVID-19 and Acute Respiratory Distress Syndrome.Case reports in pediatrics · 2024Article
- Predictors of Non-invasive Ventilation Failure and Associated Factors Among the COVID-19 Patients Admitted to Intensive Care Unit.Anesthesiology and pain medicine · 2023Article
- High-flow nasal cannula therapy in patients with COVID-19 in intensive care units in a country with limited resources: a single-center experience.The Journal of international medical research · 2023Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundHigh flow nasal cannula (HFNC) therapy is widely employed in acute hypoxemic respiratory failure (AHRF) patients. However, the techniques for predicting HFNC outcome remain scarce.
methodsPubMed, EMBASE, and Cochrane Library were searched until April 20, 2021. We included the studies that evaluated the potential predictive value of ROX (respiratory rate-oxygenation) index for HFNC outcome. This meta-analysis determined sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score, diagnostic odds ratio (DOR), and pooled area under the summary receiver operating characteristic (SROC) curve.
resultsWe assessed nine studies with 1933 patients, of which 745 patients experienced HFNC failure. This meta-analysis found that sensitivity, specificity, PLR, NLR, diagnostic score, and DOR of ROX index in predicting HFNC failure were 0.67 (95% CI 0.57-0.76), 0.72 (95% CI 0.65-0.78), 2.4 (95% CI 2.0-2.8), 0.46 (95% CI 0.37-0.58), 1.65(95% CI 1.37-1.93), and 5.0 (95% CI 4.0-7.0), respectively. In addition, SROC was 0.75 (95% CI 0.71-0.79). Besides, our subgroup analyses revealed that ROX index had higher sensitivity and specificity for predicting HFNC failure in COVID-19 patients, use the cut-off value > 5, and the acquisition time of other times after receiving HFNC had a greater sensitivity and specificity when compared to 6 h.
conclusionsThis study demonstrated that ROX index could function as a novel potential marker to identify patients with a higher risk of HFNC failure. However, the prediction efficiency was moderate, and additional research is required to determine the optimal cut-off value and propel acquisition time of ROX index in the future. PROSPERO registration number: CRD42021240607.
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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.