Utility of Heart Rate, Acidosis, Consciousness, Oxygenation, and Respiratory Rate Score in Predicting Noninvasive Ventilation Failure and Outcome in Patients with Respiratory Failure: A Prospective Cohort Study

Background: Despite various studies suggesting that a heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) score >5 predicts noninvasive ventilation (NIV) failure, a population-based study is lacking. This study aimed to assess the utility of the HACOR score in predicting NIV failure, hospital stay, and mortality among patients with respiratory failure. Materials and Methods: A prospective cohort study was conducted among patients (aged ≥18 years) who presented with acute respiratory failure in the intensive care unit of a teaching hospital. The HACOR score was calculated prior to NIV (HACOR1), 1 h (HACOR 2), and 12 h (HACOR 3) after NIV initiation. Length of hospital stay and mortality rates were observed. The data were statistically analyzed. Results: A total of 112 patients (77 males and 35 females) were included in the study. HACOR 2 predicted NIV failure ( P < 0.001). Patients with HACOR2 scores ≤5 had a 43.2 times higher chance of NIV success (95% confidence interval, 8.7859–212.18; P < 0.001). The accuracy, sensitivity, and specificity values of the HACOR 2 score (cutoff value 5) were 82.1%, 41.7%, and 93.2%, respectively, with a very good area under the curve of 0.864. The duration of hospital stay was longer among patients with HACOR 1 and 2 scores >5 ( P < 0.05). A HACOR 3 score >5 showed increased mortality. Conclusion: A HACOR 2 score ≤5 can be used to predict success and is a useful guide for invasive mechanical ventilation. HACOR 1 and 2 scores ≤5 showed a shorter duration of hospital stay. Increased mortality was found among HACOR 3 score of >5.