Role of prognostic scores in predicting in-hospital mortality and failure of non-invasive ventilation in adults with COVID-19

• DOI: 10.1007/s11739-022-03058-x
• Publication Date: 2022-08-02T20:02:25Z
• Authors: Francesca Innocenti; Cristian Lazzari; Elisa Paolucci; Anna De Paris; Alessia Lagomarsini; Federica Guerra; Patrizia Alleonato; Lisa Casalini; Michele Buggea; Francesca Caldi; Maurizio Zanobetti; Filippo Pieralli; Giulia Guazzini; Lisa Lastraioli; Fabio Luise; Alessandro Milia; Lucia Sammicheli; Lucia Maddaluni; Federico Lavorini; Riccardo Pini
• Keywords: Adult; Male; Aged, 80 and over; Noninvasive Ventilation; COVID-19; EM - Original; Middle Aged; Prognosis; Respiration, Artificial; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Hospital Mortality; Respiratory Insufficiency; Aged; Retrospective Studies

Abstract We tested the prognostic performance of different scores for identification subjects with acute respiratory failure by COVID-19, at risk in-hospital mortality and NIV failure. conducted a retrospective study, in Medical High-Dependency Unit University-Hospital Careggi. included all COVID-19 ARF requiring non-invasive ventilation (NIV) between March 2020 January 2021. Clinical parameters, HACOR score (Heart rate, Acidosis, Consciousness, Oxygenation, Respiratory Rate) ROX index ((SpO2/FiO2)/respiratory rate) were collected 3 (-3) 1 day (-1) before initiation, first treatment (Day0) after (+1), 2 (+2), 5 (+5), 8 (+8) 11 (+11) treatment. The primary outcomes 135 subjects, mean age 69±13 years, 69% male. Patients, who needed mechanical ventilation, showed higher (Day0: 6 [5-7] vs [6-7], p=.057; Day+2: [6-6] [4-6], p=.013) lower 4.2±2.3 5.1±2.3, p=.055; 4.4±1.2.vs 5.5±1.3, p=.001) than those successful NIV. An >5 was more frequent among nonsurvivors 82% 58%; Day2: 48%, p<0.01) it associated RR 5.88, 95%CI 2.01-17.22; 4.33, 1.64-11.41) independent to Charlson index. In conclusion, treated caused COVID19, parameters beginning allowed identify an adverse outcome. independently increased rate.