Non-invasive Ventilation Outcome (NIVO) score for predicting in- hospital and late mortality of chronic obstructive pulmonary disease (COPD) patients with acute hypercapnia

BACKGROUND AND AIM: Mortality and morbidity increase with acute hypercapnic respiratory failure during chronic obstructive pulmonary disease (COPD) exacerbation.Due to the lack of adequate prognostic scoring systems for assessing mortality in patients with acute hypercapnic respiratory failure during COPD exacerbation, we aimed to assess the efficacy of the NIVO score as a predictor of in-hospital and late mortality in COPD patients with acute hypercapnic respiratory failure. METHODS:This retrospective cross-sectional study was conducted in a tertiary research and training hospital for chest diseases from November 2019 to November 2021, and included patients with COPD who were hospitalized with exacerbation requiring assisted ventilation.The patients' demographic characteristics, laboratory data, and clinical information were collected from the hospital database.Patients were classified according to their NIVO score.In-hospital and late mortality rates were recorded. RESULTS:The study included 250 COPD patients with acute hypercapnic respiratory failure.The majority of patients (42%) classified according to the NIVO score were in the moderate-risk group.The intubation rate due to Non-Invasive Mechanical Ventilation (NIMV) failure in the high-risk group based on the NIVO score was 38.8%, while the rates in the moderate-and low-risk groups were 9.5% and 8%, respectively.The high-risk group had a significantly higher risk of intubation compared to the moderate-and low-risk groups (p<0.001).Increased risk levels according to the NIVO score were associated with significantly higher in-hospital and late mortality rates (p<0.001). CONCLUSIONS:The novel and easy-to-use NIVO score is important for predicting the prognosis of COPD patients with exacerbation requiring assisted ventilation.