ArticleBMC pulmonary medicine2026
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.
Article in BMC pulmonary medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe respiratory rate-oxygenation (ROX) index (calculated as [SpO₂/FiO₂ ratio] / respiratory rate) is reported to be associated with outcomes in patients with acute hypoxemic respiratory failure treated with a high-flow nasal cannula (HFNC). However, its prognostic utility in acute exacerbation of interstitial lung disease (AE-ILD) remains unclear.
methodsWe conducted a single-center retrospective cohort study that included patients with AE-ILD who received HFNC between April 2016 and June 2023. The ROX index at HFNC initiation (0 h) and 12 h was recorded. The primary outcome was 30-day mortality. Logistic regression analysis was also performed.
resultsIn total, 92 patients were included in this study; their median age was 80 years, and 73% were male. Univariate analysis revealed that 30-day mortality was associated with the ROX index at 0 h (odds ratio [OR], 0.80; 95% confidence interval [CI]: 0.63-1.00; p = 0.048) and 12 h (OR, 0.66; 95% CI: 0.50-0.85; p = 0.001). Multivariate analysis revealed that the ROX index at 12 h was independently associated with 30-day mortality (OR, 0.67; 95% CI: 0.51-0.88; p = 0.003). The optimal cutoff value of the ROX index at 12 h for 30-day mortality was 5.82 (area under the curve: 0.76).
conclusionsThe ROX index at 12 h after HFNC was associated with 30-day mortality in patients with AE-ILD and may serve as a simple bedside marker for short-term prognosis.
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