Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patients
Background Scales that detect noninvasive ventilation (NIV) failure need to have adequate clinimetric properties to be reliable. This study aimed to compare the clinimetric properties of the Heart rate, Acidosis, Consciousness, Oxygenation, Respiratory rate (HACOR) and updated HACOR scales when appl...
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Korean Society of Critical Care Medicine
2025-05-01
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| Series: | Acute and Critical Care |
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| Online Access: | http://accjournal.org/upload/pdf/acc-000175.pdf |
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| author | Matheus Pereira Nunes da Silva Adriana Claudia Lunardi |
| author_facet | Matheus Pereira Nunes da Silva Adriana Claudia Lunardi |
| author_sort | Matheus Pereira Nunes da Silva |
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| description | Background Scales that detect noninvasive ventilation (NIV) failure need to have adequate clinimetric properties to be reliable. This study aimed to compare the clinimetric properties of the Heart rate, Acidosis, Consciousness, Oxygenation, Respiratory rate (HACOR) and updated HACOR scales when applied to hypoxemic adult patients undergoing NIV. Methods This prospective study applied the HACOR and updated HACOR scales to hypoxemic patients after one hour of NIV in an emergency department setting. A second application of the scales was performed after ten minutes to assess reliability (intraclass correlation coefficient), measurement error (standard error of measurement and minimum detectable difference), ceiling and floor effects, convergent validity by correlation (Pearson’s r) with peripheral oximetry saturation (SpO2), and predictive validity (area under the receiver operating characteristic [ROC] curve) for the outcome of needing invasive mechanical ventilation. Results Sixty patients were included in this study (59.45±17.48 years; Simplified Acute Physiology Score III, 56.1±13.95; 30% with respiratory disease and 25% with cardiovascular disease). After 1 hour of NIV, patients had a HACOR score of 3 (interquartile range [IQR], 1.0–5.0) and an updated HACOR score of 5 (IQR, 3.0–8.87). Clinimetric properties were adequate for both versions of the HACOR scale but were superior for the updated version, including predictive validity (ROC [95% CI], 0.78 [0.64–0.91] vs. 0.73 [0.57–0.89]) and the absence of the ceiling effect. Conclusions Both versions of the HACOR scale demonstrated adequate clinimetric properties for predicting NIV failure, with the updated HACOR version showing superior predictive validity and no ceiling effect compared with the original version. |
| format | Article |
| id | doaj-art-3403ced016764858927ede2fbb8cea3c |
| institution | Kabale University |
| issn | 2586-6052 2586-6060 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Korean Society of Critical Care Medicine |
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| series | Acute and Critical Care |
| spelling | doaj-art-3403ced016764858927ede2fbb8cea3c2025-08-20T03:30:44ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602025-05-0140232232910.4266/acc.0001751605Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patientsMatheus Pereira Nunes da Silva0Adriana Claudia Lunardi1 Master and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brasil Master and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, BrasilBackground Scales that detect noninvasive ventilation (NIV) failure need to have adequate clinimetric properties to be reliable. This study aimed to compare the clinimetric properties of the Heart rate, Acidosis, Consciousness, Oxygenation, Respiratory rate (HACOR) and updated HACOR scales when applied to hypoxemic adult patients undergoing NIV. Methods This prospective study applied the HACOR and updated HACOR scales to hypoxemic patients after one hour of NIV in an emergency department setting. A second application of the scales was performed after ten minutes to assess reliability (intraclass correlation coefficient), measurement error (standard error of measurement and minimum detectable difference), ceiling and floor effects, convergent validity by correlation (Pearson’s r) with peripheral oximetry saturation (SpO2), and predictive validity (area under the receiver operating characteristic [ROC] curve) for the outcome of needing invasive mechanical ventilation. Results Sixty patients were included in this study (59.45±17.48 years; Simplified Acute Physiology Score III, 56.1±13.95; 30% with respiratory disease and 25% with cardiovascular disease). After 1 hour of NIV, patients had a HACOR score of 3 (interquartile range [IQR], 1.0–5.0) and an updated HACOR score of 5 (IQR, 3.0–8.87). Clinimetric properties were adequate for both versions of the HACOR scale but were superior for the updated version, including predictive validity (ROC [95% CI], 0.78 [0.64–0.91] vs. 0.73 [0.57–0.89]) and the absence of the ceiling effect. Conclusions Both versions of the HACOR scale demonstrated adequate clinimetric properties for predicting NIV failure, with the updated HACOR version showing superior predictive validity and no ceiling effect compared with the original version.http://accjournal.org/upload/pdf/acc-000175.pdfacute respiratory failurenoninvasive ventilationpsychometricsreproducibility of resultsvalidation study |
| spellingShingle | Matheus Pereira Nunes da Silva Adriana Claudia Lunardi Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patients Acute and Critical Care acute respiratory failure noninvasive ventilation psychometrics reproducibility of results validation study |
| title | Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patients |
| title_full | Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patients |
| title_fullStr | Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patients |
| title_full_unstemmed | Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patients |
| title_short | Comparison of the clinimetric properties of the two versions of the HACOR scale for predicting noninvasive ventilation failure in Brazilian patients |
| title_sort | comparison of the clinimetric properties of the two versions of the hacor scale for predicting noninvasive ventilation failure in brazilian patients |
| topic | acute respiratory failure noninvasive ventilation psychometrics reproducibility of results validation study |
| url | http://accjournal.org/upload/pdf/acc-000175.pdf |
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