Validity of the ROX index in predicting invasive mechanical ventilation requirement in pneumonia
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URI: http://hdl.handle.net/10818/54580Visitar enlace: https://bmjopenrespres.bmj.com ...
ISSN: 2052-4439
DOI: 10.1136/bmjresp-2022-001320
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Reyes, Luis F.; Bastidas Goyes, Alirio; Tuta Quintero, Eduardo Andrés; Pedreros, Karen D.; Mantilla, Yesid F.; Herrera, Manuela; Carmona, Germán A.; Saza, Laura D.; Pineda, Andrés F.Data
2022Resumo
Background The ROX index (Respiratory rate-OXygenation) 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.
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BMJ Open Respiratory Research. 9(1):1-8
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