Observational studyCritical care (London, England)2022
An updated HACOR score for predicting the failure of noninvasive ventilation: a multicenter prospective observational study.
Observational study in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.
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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
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.
- Incidence of noninvasive ventilation failure and mortality in patients with acute respiratory distress syndrome: a systematic review and proportion meta-analysis.BMC pulmonary medicine · 2024Pooled it
- Low versus high positive end expiratory pressure in noninvasive ventilation for hypoxemic respiratory failure: a multicenter randomized controlled trial.Intensive care medicine · 2025Trial
- 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
- Review
- 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
- Development of an Artificial Intelligence Model to Predict Endotracheal Intubation in Critically Ill Patients in Real Time.Journal of clinical medicine · 2026Article
- Rehabilitating the diaphragm: an integrated approach to intensive care unit-acquired dysfunction in critical illness-a narrative review.Acute and critical care · 2026Article
- [72/m with acute dyspnea and onset of impaired consciousness : Preparation for the medical specialist examination: part 2].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Factors Associated with Outcomes of Non-Invasive Ventilation in Acute Hypercapnic Respiratory Failure with Acidosis: A Study from a Tertiary Care Hospital in Pakistan.Journal of clinical medicine · 2026Article
- In-hospital testing of NIVPredict - an AI tool for early prediction of non-invasive ventilation outcome in acute respiratory failure.Critical care (London, England) · 2026Article
- Two-hour dynamic reassessment of noninvasive ventilation failure risk in acute exacerbation of chronic obstructive pulmonary disease with hypercapnic respiratory failure: development and temporal validation.Frontiers in medicine · 2026Article
- Early Prediction of High-flow Nasal Cannula Failure in Children: Clarifying the Evidence Behind the Pediatric HACOR Score.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Oxygenation in acute exacerbation of interstitial lung disease:a nationwide survey.Scientific reports · 2025Article
- Non-Invasive Respiratory Support for Acute Cardiogenic Pulmonary Edema in the Acute Care Setting.Current heart failure reports · 2025Review
- Early Prediction of High-flow Nasal Cannula Failure Using Pediatric-modified HACOR Score in Children with Acute Hypoxemic Respiratory Distress: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Predicting weaning failure from invasive mechanical ventilation: The promise and pitfalls of clinical prediction scores.World journal of critical care medicine · 2025Review
- A Multicenter Retrospective Study Predicting Early Noninvasive Ventilation Failure in Patients With Acute Hypoxic Respiratory Failure.The clinical respiratory journal · 2025Article
- Can we predict the future of respiratory failure prediction?Critical care (London, England) · 2025Review
- Prevalence, risk factors and consequences of early clinical deterioration under non-invasive ventilation in emergency department patients: a prospective, multicentre, observational study of the French IRU Network.Critical care (London, England) · 2025Observational
Corrections and comments
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Authors and funding
26 authors at 15 institutions in 4 countries.
Funding
Abstract
backgroundHeart 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.
methodsA 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.
resultsBefore 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 vs. 0.71, 0.79 vs. 0.74, and 0.81 vs. 0.76, respectively; all p values < 0.01). When 7, 10.5, and 14 points of the updated HACOR score were used as cutoff values, the probability of NIV failure was 25%, 50%, and 75%, respectively. Among patients with updated HACOR scores of ≤ 7, 7.5-10.5, 11-14, and > 14 after 1-2 h of NIV, the rate of NIV failure was 12.4%, 38.2%, 67.1%, and 83.7%, respectively.
conclusionsThe updated HACOR score has high predictive power for NIV failure in patients with hypoxemic respiratory failure. It can be used to help in decision-making when NIV is used.
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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.