Evaluation of diagnostic accuracy of HACOR index in predicting the success rate of CPAP in patients with Covid-۱۹-induced hypoxemia

Introduction: Having a suitable criterion to evaluate the success rate of Non-invasiveVentilation (NIV) is important because it predicts the early detection of failure or success ofNIV and intubation and can significantly reduce mortality. Hence, this study was conducted toevaluate the diagnostic accuracy of the Heart rate, Acidosis, Consciousness, Oxygenation,Respiratory rate (HACOR) index in predicting the success rate of Continuous Positive AirwayPressure (CPAP) in patients with Covid-۱۹-induced hypoxemia.Materials and methods: This retrospective cross-sectional study was conducted on ۲۰۰ adultpatients aged ۶۳.۲۳±۱۶.۲۳ years with acute to moderate acute respiratory failure (Covid-۱۹)and Pao۲<۳۰۰ mmHg and PaCO۲<۴۵ mmHg from March ۲۱ to November ۲۱, ۲۰۲۱. Thepatients were admitted to the Respiratory Intensive Care Unit (RICU) of Khatam Al-AnbiaHospital in Shoushtar (southwestern Iran) and were subjected to CPAP for respiratory support.The HACOR index was calculated one hour after the CPAP onset. Data were analyzed by SPSSsoftware (version ۲۲) using Mann-Whitney, chi-square (or Fisher’s exact), and Wilcoxon tests.ROC curve and sensitivity, specificity, and predictive value indices were used to determine thediagnostic accuracy of the method. The significance level was set at p≤۰.۰۵.Results: The mean HACOR index one hour after the onset of CPAP was ۳.۵۰±۱.۵۷ (P=۰.۰۰۰),with a mean of ۱۵۳.۸۴±۲۷.۴۲ mmHg PaO۲/FiO۲ (P=۰.۰۰۰). Out of ۲۰۰ patients, ۱۵۷ patients(۷۸.۵%) had CPAP failure and ۴۳ patients (۲۱.۵%) underwent treatment. The diagnosticaccuracy values of HACOR and PaO۲/FiO۲ for predicting CPAP failure were ۹۴.۹۲% and۹۵.۹۶%, respectively.Conclusion: The HACOR index and PaO۲/FiO۲ can have good diagnostic performance inpredicting the failure of non-invasive CPAP in Covid-۱۹ patients with Acute Renal Failure(ARF).