Background. A rating scale that takes into account heart rate, acidosis, consciousness, oxygenation, and respiratory rate (the HACOR score) has been used to predict noninvasive ventilation (NIV) failure in patients with chronic obstructive pulmonary disease (COPD). However, the HACOR score has not been used to predict NIV failure in non-COPD patients with acute-on-chronic respiratory failure. Methods. This study was performed in the respiratory intensive care unit of a teaching hospital. Data had been collected prospectively between June 2011 and January 2019. We enrolled non-COPD patients who received NIV due to acute-on-chronic respiratory failure, pH < 7.35, and PaCO₂ >45 mmHg. NIV failure was defined as requiring intubation or dying during NIV. The HACOR score was determined at initiation and after 1-2, 12, and 24 h of NIV. Scores can range from 0 to 27, with higher scores indicating a higher risk of NIV failure. Results. A total of 148 patients were enrolled in the study, 52 with sleep apnea-hypopnea syndrome, 34 with chronic thoracic sequelae, 31 with bronchiectasis, 14 with chest wall deformity, 5 with obesity-hypoventilation syndrome, and 12 with other conditions. Of the patients, 19 (13%) experienced NIV failure. From initiation to 24 h of NIV, the HACOR scores of patients who experienced NIV failure were much higher than those of patients who received successful NIV. The area under the receiver operating characteristic curve was 0.69, 0.91, 0.91, and 0.94 when the HACOR score was tested at initiation and after 1-2, 12, and 24 h of NIV, respectively. To obtain the best sensitivity and specificity, the cutoff value at initiation was 7 with a sensitivity of 68% and a specificity of 61%. After 1-2 h of NIV, it was 5 with a sensitivity of 90% and a specificity of 85%. After 12 h of NIV, it was 4 with a sensitivity of 82% and a specificity of 91%. After 24 h of NIV, it was 2 with a sensitivity of 100% and a specificity of 76%. Conclusions. The HACOR score has high sensitivity and specificity for predicting NIV failure among non-COPD patients who receive NIV due to acute-on-chronic respiratory failure with respiratory acidosis.

中文翻译：

---

HACOR 评分对非 COPD 急性加慢性呼吸衰竭患者无创通气失败的影响

背景。考虑到心率、酸中毒、意识、氧合和呼吸频率（HACOR 评分）的评分量表已被用于预测慢性阻塞性肺病 (COPD) 患者的无创通气 (NIV) 失败。然而，HACOR 评分尚未用于预测患有慢加急性呼吸衰竭的非 COPD 患者的 NIV 失败。方法。这项研究是在教学医院的呼吸重症监护病房进行的。数据是在 2011 年 6 月至 2019 年 1 月期间前瞻性收集的。我们招募了因慢性加急呼吸衰竭、pH < 7.35 和 PaCO _{2而接受 NIV 的非 COPD 患者}>45 毫米汞柱。NIV 失败被定义为在 NIV 期间需要插管或死亡。HACOR 评分在 NIV 开始时和 1-2、12 和 24 小时后确定。分数范围从 0 到 27，分数越高表明 NIV 失败的风险越高。结果. 共有 148 名患者入组，其中睡眠呼吸暂停低通气综合征 52 名，慢性胸部后遗症 34 名，支气管扩张 31 名，胸壁畸形 14 名，肥胖低通气综合征 5 名，其他 12 名。在这些患者中，19 名 (13%) 经历了 NIV 失败。从 NIV 开始到 24 小时，经历 NIV 失败的患者的 HACOR 评分远高于接受 NIV 成功的患者。接受者操作特征曲线下面积分别为 0.69、0.91、0.91 和 0.94，在 NIV 开始时和 1-2、12 和 24 小时后测试 HACOR 评分。为了获得最佳的敏感性和特异性，开始时的临界值为 7，敏感性为 68%，特异性为 61%。NIV 1-2 小时后，它是 5，灵敏度为 90%，特异性为 85%。NIV 12 小时后为 4，敏感性为 82%，特异性为 91%。NIV 24 h 后为 2，敏感性为 100%，特异性为 76%。结论。HACOR评分在预测因慢性加急呼吸衰竭伴呼吸性酸中毒而接受NIV的非COPD患者中具有较高的敏感性和特异性。