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Research Paper | Medical Science | Volume 15 Issue 6, June 2026 | Pages: 664 - 670 | India
Utility of the Updated HACOR Score in Predicting Non-Invasive Ventilation Failure in Acute Hypoxemic Respiratory Failure: A Prospective Observational Study from India
Abstract: Background: Non-invasive ventilation (NIV) is widely used in acute hypoxemic respiratory failure (AHRF). The HACOR score predicts NIV failure, but its utility in non-COPD AHRF is limited. The updated HACOR score incorporates additional predictors and may provide improved accuracy. Objectives: To evaluate the utility of the updated HACOR score in predicting NIV failure in AHRF and compare it with the original HACOR score. Methods: This was a prospective observational study in a tertiary-care hospital in India. Fifty adults with AHRF initiated on NIV were enrolled. Clinical and arterial blood gas analysis data were collected. HACOR and updated HACOR scores were calculated. Receiver operating characteristic (ROC) curves were used to assess predictive accuracy. Results: Among 50 patients, 35 (70%) had successful NIV, and 15 (30%) failed. Lower respiratory tract infection (82%) and cardiogenic pulmonary edema (40%) were common causes. 40% of NIV failures occurred within 12 hours of initiating NIV. Patients with NIV failure had higher respiratory rates (36.1 ± 6 vs. 29.4 ± 4.9/min, p = 0.01), lower PaO?/FiO? ratios (218.6 ± 37.3 vs. 243.3 ± 29.0, p = 0.01 at presentation and 211.4 ± 49.4 vs. 248.0 ± 38.7, p = 0.01 at 1 hour), and higher updated HACOR scores (12.6 ± 2.1 vs. 7.4 ± 2.3, p < 0.001). Conclusion: The updated HACOR score demonstrated higher predictive accuracy than the conventional HACOR score for identifying NIV failure in patients with acute hypoxemic respiratory failure. Early application of the score may facilitate timely escalation of respiratory support and improve clinical decision-making in intensive care settings.
Keywords: acute hypoxemic respiratory failure, non-invasive ventilation, Updated HACOR score, predictive accuracy, NIV failure, critical care
How to Cite?: Ved Prakash Yadav, Praveen Bharti, Sandeep Garg, Amit Kumar, Shweta Ambedare, "Utility of the Updated HACOR Score in Predicting Non-Invasive Ventilation Failure in Acute Hypoxemic Respiratory Failure: A Prospective Observational Study from India", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 664-670, https://www.ijsr.net/getabstract.php?paperid=SR26610232654, DOI: https://dx.dx.doi.org/10.21275/SR26610232654