ROX index as a good predictor of high flow nasal cannula failure in COVID-19 patients with acute hypoxemic respiratory failure: A systematic review and meta-analysis.
ROX index as a good predictor of high flow nasal cannula failure in COVID-19 patients with acute hypoxemic respiratory failure: A systematic review and meta-analysis.
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DOI：
10.1016/j.jcrc.2021.08.012
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发表时间：
2021-12
影响因子：
3.7
通讯作者：
Prasad K
中科院分区：
文献类型：
--
作者：
Prakash J;Bhattacharya PK;Yadav AK;Kumar A;Tudu LC;Prasad K
预测新冠肺炎急性低氧性呼吸衰竭患者高流量鼻插管失败可能会改善临床管理和患者分层，从而获得最佳治疗。我们进行了系统的综述和荟萃分析，以确定ROX指数作为HFNC失败的预测因子的表现。在电子数据库(PubMed、Google Scholar、Web of Science和Cochrane Library)中系统地搜索到2021年6月15日发表的研究ROX指数作为HFNC失败的预测因子的文章。两位独立作者使用预后质量研究(QUPS)工具来分析预后因素的偏倚风险。对1301例患者的8项回顾或前瞻性队列研究显示，预测HNFC失败的判别值为0.81(95%CI，0.77~0.84)，敏感性为0.70(95%CI，0.59~0.80)，特异性为0.79(95%CI，0.67~0.88)。阳性似然比和阴性似然比分别为3.0(95%CI，2.2~5.3)和0.37(95%CI，0.28~0.50)，并与良好的预测准确性(诊断优势比(DOR)9，95%CI，5~16)密切相关。Meta分析提示，ROX指数对新冠肺炎急性高血压性肾衰患者肾功能衰竭的预测有较好的鉴别能力。
Prediction of high flow nasal cannula (HFNC) failure in COVID-19 patients with acute hypoxemic respiratory failure (AHRF) may improve clinical management and stratification of patients for optimal treatment. We performed a systematic review and meta-analysis to determine performance of ROX index as a predictor of HFNC failure. Systematic search was performed in electronic databases (PubMed, Google Scholar, Web of Science and Cochrane Library) for articles published till 15 June 2021 investigating ROX index as a predictor for HFNC failure. Quality In Prognosis Studies (QUIPS) tool was used to analyze risk of bias for prognostic factors, by two independent authors. Eight retrospective or prospective cohort studies involving 1301 patients showed a good discriminatory value, summary area under the curve (sAUC) 0.81 (95% CI, 0.77–0.84) with sensitivity of 0.70 (95% CI, 0.59–0.80) and specificity of 0.79 (95% CI, 0.67–0.88) for predicting HNFC failure. The positive and negative likelihood ratio were 3.0 (95% CI, 2.2–5.3) and 0.37 (95% CI, 0.28–0.50) respectively, and was strongly associated with a promising predictive accuracy (Diagnostic odds ratio (DOR) 9, 95% CI, 5–16). This meta-analysis suggests ROX index has good discriminating power for prediction of HFNC failure in COVID-19 patients with AHRF.
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