Cambios longitudinales en el índice de ROX y el puntaje de HACOR en pacientes críticos con insuficiencia respiratoria aguda por COVID-19 que requirieron cánula nasal de alto flujo: estudio de cohorte retrospectivo

Objectives

Validate the IROX and HACOR scores, including their deltas, in determining their success, defined as survival and the need for intubation.

Design

Retrospective cohort study involving 115 patients admitted to intensive care for acute hypoxemic respiratory failure (AHRF) and treated with high-flow nasal cannula (HFNC).

Materials and methods

IROX and HACOR scores were evaluated at the initiation of HFNC use and at 24 hours (delta).

Background

In patients with AHRF due to SARS-CoV-2, the study aimed to determine the success of HFNC by evaluating this index and score and their respective deltas at 24 hours.

Results

At 24 hours, the IROX was higher in the success group (6.53 [4.80-10.44] vs. 4.76 [4.11-5.90]) and the HACOR was lower (4 [2-6] vs. 6 [5-6.75]), both results being significant (p = < 0.001). The D-ROX was positively associated with survival (47.37 [-1.89-136.11] vs. 5.06 [-16.85-34.25]; p = 0.002), contrary to the D-HACOR (-25 [-66.67-0] vs. 0 [-16.67-16.67]; p = < 0.001). Multivariate analysis of D-IROX (HR = 0.99, 95%CI [0.99-1], p = 0.001) and D-HACOR (HR = 1.01, 95%CI [1-1.01], p = 0.001) indicated that both are valid predictors of survival and failure.

Conclusion

The IROX and HACOR scores at 24 hours, along with their deltas, are good predictors of success.