HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients

Aim:To compare the diagnostic accuracy of HACOR score in predicting non-invasive ventilation (NIV) failure among acute exacerbation of chronic obstructive airway disease and acute decompensated heart failure patients, and study the correlation of HACOR score with a length of stay and hospital mortal...

Full description

Bibliographic Details
Main Authors: Yong Hup Teh, Mohd Zahir Amin Mohd Nazri, Abdul Muhaimin Noor Azhar, Rabiha Mohd Alip
Format: Article
Language:English
Published: Galenos Yayinevi 2022-09-01
Series:Eurasian Journal of Emergency Medicine
Subjects:
Online Access: http://eajem.com/archives/archive-detail/article-preview/hacor-score-in-predicting-non-invasive-ventilation/52931
_version_ 1797910439540031488
author Yong Hup Teh
Mohd Zahir Amin Mohd Nazri
Abdul Muhaimin Noor Azhar
Rabiha Mohd Alip
author_facet Yong Hup Teh
Mohd Zahir Amin Mohd Nazri
Abdul Muhaimin Noor Azhar
Rabiha Mohd Alip
author_sort Yong Hup Teh
collection DOAJ
description Aim:To compare the diagnostic accuracy of HACOR score in predicting non-invasive ventilation (NIV) failure among acute exacerbation of chronic obstructive airway disease and acute decompensated heart failure patients, and study the correlation of HACOR score with a length of stay and hospital mortality rate.Materials and Methods:A prospective observational study was conducted in the Emergency Department of Hospital Melaka. We enrolled patients who presented with acute respiratory distress and started them with NIV. The efficacy of the HACOR score is evaluated at several interval time points, before NIV initiation, 1 h, 2 h post NIV initiation.Results:HACOR score is much lower in NIV success subgroups and 100% NIV failure rate for the HACOR score more than 7 at 1 h and 2 h of NIV. With a cut-off value of more than 5 in 1 h of NIV, the diagnostic power is 86.27% with a sensitivity of 62.50% and specificity of 90.70%. While at 2 h of NIV the HACOR score of more than 5, its diagnostic power is 87.50% a sensitivity of 50% and specificity of 95%. In 0-2 hours of NIV, area under the curve for predicting NIV failure was 0.788, 0.868 and 0.925, respectively.Conclusion:The HACOR has good diagnostic accuracy when it is assessed at 1-2 h of NIV. It is convenient to use it to assess the efficacy of NIV especially for heart failure patients. However, HACOR score was a weak predictor of mortality in our study. The length of hospital stay was also found to be longer for those who failed to respond to NIV in our study.
first_indexed 2024-04-10T11:24:22Z
format Article
id doaj.art-4f3775ef370d4538a1a4d615773bba08
institution Directory Open Access Journal
issn 2149-5807
2149-6048
language English
last_indexed 2024-04-10T11:24:22Z
publishDate 2022-09-01
publisher Galenos Yayinevi
record_format Article
series Eurasian Journal of Emergency Medicine
spelling doaj.art-4f3775ef370d4538a1a4d615773bba082023-02-15T16:18:30ZengGalenos YayineviEurasian Journal of Emergency Medicine2149-58072149-60482022-09-0121316517510.4274/eajem.galenos.2022.0973413049054HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD PatientsYong Hup Teh0Mohd Zahir Amin Mohd Nazri1Abdul Muhaimin Noor Azhar2Rabiha Mohd Alip3 University of Malaya Faculty of Medicine, Department of of Emergency, Kuala Lumpur, Malaysia University of Malaya Faculty of Medicine, Department of of Emergency, Kuala Lumpur, Malaysia University of Malaya Faculty of Medicine, Department of of Emergency, Kuala Lumpur, Malaysia Hospital Melaka, Department of Emergency, Melaka, Malaysia Aim:To compare the diagnostic accuracy of HACOR score in predicting non-invasive ventilation (NIV) failure among acute exacerbation of chronic obstructive airway disease and acute decompensated heart failure patients, and study the correlation of HACOR score with a length of stay and hospital mortality rate.Materials and Methods:A prospective observational study was conducted in the Emergency Department of Hospital Melaka. We enrolled patients who presented with acute respiratory distress and started them with NIV. The efficacy of the HACOR score is evaluated at several interval time points, before NIV initiation, 1 h, 2 h post NIV initiation.Results:HACOR score is much lower in NIV success subgroups and 100% NIV failure rate for the HACOR score more than 7 at 1 h and 2 h of NIV. With a cut-off value of more than 5 in 1 h of NIV, the diagnostic power is 86.27% with a sensitivity of 62.50% and specificity of 90.70%. While at 2 h of NIV the HACOR score of more than 5, its diagnostic power is 87.50% a sensitivity of 50% and specificity of 95%. In 0-2 hours of NIV, area under the curve for predicting NIV failure was 0.788, 0.868 and 0.925, respectively.Conclusion:The HACOR has good diagnostic accuracy when it is assessed at 1-2 h of NIV. It is convenient to use it to assess the efficacy of NIV especially for heart failure patients. However, HACOR score was a weak predictor of mortality in our study. The length of hospital stay was also found to be longer for those who failed to respond to NIV in our study. http://eajem.com/archives/archive-detail/article-preview/hacor-score-in-predicting-non-invasive-ventilation/52931 hacor scoreacute exacerbation of chronic obstructive airway diseaseacute respiratory failurechronic obstructive pulmonary diseaseacute decompensated heart failurenon-invasive ventilation
spellingShingle Yong Hup Teh
Mohd Zahir Amin Mohd Nazri
Abdul Muhaimin Noor Azhar
Rabiha Mohd Alip
HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients
Eurasian Journal of Emergency Medicine
hacor score
acute exacerbation of chronic obstructive airway disease
acute respiratory failure
chronic obstructive pulmonary disease
acute decompensated heart failure
non-invasive ventilation
title HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients
title_full HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients
title_fullStr HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients
title_full_unstemmed HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients
title_short HACOR Score in Predicting Non-invasive Ventilation Failure in Acute Decompensated Heart Failure and AECOAD Patients
title_sort hacor score in predicting non invasive ventilation failure in acute decompensated heart failure and aecoad patients
topic hacor score
acute exacerbation of chronic obstructive airway disease
acute respiratory failure
chronic obstructive pulmonary disease
acute decompensated heart failure
non-invasive ventilation
url http://eajem.com/archives/archive-detail/article-preview/hacor-score-in-predicting-non-invasive-ventilation/52931
work_keys_str_mv AT yonghupteh hacorscoreinpredictingnoninvasiveventilationfailureinacutedecompensatedheartfailureandaecoadpatients
AT mohdzahiraminmohdnazri hacorscoreinpredictingnoninvasiveventilationfailureinacutedecompensatedheartfailureandaecoadpatients
AT abdulmuhaiminnoorazhar hacorscoreinpredictingnoninvasiveventilationfailureinacutedecompensatedheartfailureandaecoadpatients
AT rabihamohdalip hacorscoreinpredictingnoninvasiveventilationfailureinacutedecompensatedheartfailureandaecoadpatients