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THE VALUE OF THE HACOR SCALE IN PREDICTING SUCCESS OF NON-INVASIVE VENTILATION IN PATIENTS WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
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Abstract
Objective: To evaluate HACOR scale in predicting the success of non-invasive mechanical ventilation (NIV) in patients with acute exacerbation of chronic obstructive pulmonary disease. Methods: A retrospective study evaluating the HACOR scale in 71 NIV patients with COPD exacerbations admitted to the Emergency Department of Bach Mai Hospital from January 2019 to July 2020. The HACOR scale ranges from 0 to 27 points, including Glasgow score, heart rate, breathing rate, acidosis and oxygenation. This values were collected before NIV and at 3 hours after NIV. The criteria for NIV failure defined as a requirement for intubation after NIV intervention. Results: The study on 71 COPD exacerbation patients with who needed NIV showed the failure rate of 22.5%. The HACOR score of early failed patients (< 3 hours) was higher at initiation. The area under the receiver operating characteristic curve was 0.82, showing good predictive power for NIV failure. Using the cutoff value of 5, the sensitivity, specificity, positive predictive value, negative predictive value for NIV failure were 75; 80.9; 79 and 70.1%, respectively. In patients with NIV failure after 3 hours, HACOR had an average predictive power with AUC was 0.77. Using the cutoff value of 6, the sensitivity, specificity, positive predictive value, negative predictive value for NIV failure were 56.2; 92.7; 69 and 88%, respectively. Conclusion: The HACOR scale at initiation showed good prediction for early NIV failure in patients with acute exacerbation of COPD.
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Keywords
Non-invasive mechanical ventilation, HACOR scale, acute exacerbation of chronic obstructive pulmonary disease
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