In:
BMJ Open Respiratory Research, BMJ, Vol. 9, No. 1 ( 2022-09), p. e001320-
Abstract:
The ROX index ( R espiratory rate- OX ygenation) has been described as a prediction tool to identify the need for invasive mechanical ventilation (IMV) in community-acquired pneumonia (CAP) with acute hypoxaemic respiratory failure treated with high-flow nasal cannula in order to avoid delay of a necessary intubation. However, its use in predicting the need for ventilatory support in hospitalised patients with CAP has not been validated. Methods This is a retrospective cohort study including subjects with CAP treated in the general ward, emergency service or intensive care unit of a third-level centre in Cundinamarca, Colombia, between January 2001 and February 2020. The ROX index was estimated as the ratio of oxygen saturation/fraction of inspired oxygen to respiratory rate. Results A total of 895 patients were included, of whom 93 (10%) required IMV. The ROX index proved to be a good predictor, presenting an area under the curve of receiver operating characteristics (AUROC) of 0.733 (95% CI 0.671 to 0.795, p 〈 0.001) when determined by pulse oximetry and an AUROC of 0.779 (95% CI 0.699 to 0.859, p 〈 0.001) when estimated by arterial blood gas (ABG) parameters, with an intraclass correlation of 0.894. The estimated cut-off point was 14.8; a score less than 14.8 indicates high risk of requiring IMV. Conclusion The ROX index is a good predictor of IMV in hospitalised patients with CAP. It presents good performance when calculated through pulse oximetry and can replace the one calculated by ABG.
Type of Medium:
Online Resource
ISSN:
2052-4439
DOI:
10.1136/bmjresp-2022-001320
Language:
English
Publisher:
BMJ
Publication Date:
2022
detail.hit.zdb_id:
2736454-9