Association between the ROX index and mortality in patients with acute hypoxemic respiratory failure: a retrospective cohort study

Although ROX index is frequently used to assess the efficacy of high-flow nasal cannula treatment in acute hypoxemic respiratory failure (AHRF) patients, the relationship between the ROX index and the mortality remains unclear. Therefore, a retrospective cohort study was conducted to evaluate the ab...

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Published in:Respiratory research 2024-03, Vol.25 (1), p.143-143, Article 143
Main Authors: Liu, Kai, Ma, Xin-Yi, Xiao, Hua, Gu, Wan-Jie, Lyu, Jun, Yin, Hai-Yan
Format: Article
Language:English
Subjects:
Acute hypoxemic respiratory failure
Biological markers
Care and treatment
Cerebrovascular disease
Creatinine
Diagnosis
Evaluation
Extracorporeal membrane oxygenation
Gender
Health risks
Hospitalization
Hospitals
Hypotheses
Liver diseases
MIMIC-IV
Missing data
Mortality
Mortality risk
Oxygen saturation
Patients
Potassium
Prognosis
Respiratory failure
Respiratory insufficiency
Risk
ROX index
Spline functions
Statistical analysis
Structured Query Language-SQL
Survival analysis
Variables
Ventilators
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Ma, Xin-Yi
Xiao, Hua
Gu, Wan-Jie
Lyu, Jun
Yin, Hai-Yan
description Although ROX index is frequently used to assess the efficacy of high-flow nasal cannula treatment in acute hypoxemic respiratory failure (AHRF) patients, the relationship between the ROX index and the mortality remains unclear. Therefore, a retrospective cohort study was conducted to evaluate the ability of the ROX index to predict mortality risk in patients with AHRF. Patients diagnosed with AHRF were extracted from the MIMIC-IV database and divided into four groups based on the ROX index quartiles. The primary outcome was 28-day mortality, while in-hospital mortality and follow-up mortality were secondary outcomes. To investigate the association between ROX index and mortality in AHRF patients, restricted cubic spline curve and COX proportional risk regression were utilized. A non-linear association (L-shaped) has been observed between the ROX index and mortality rate. When the ROX index is below 8.28, there is a notable decline in the 28-day mortality risk of patients as the ROX index increases (HR per SD, 0.858 [95%CI 0.794-0.928] P 
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Therefore, a retrospective cohort study was conducted to evaluate the ability of the ROX index to predict mortality risk in patients with AHRF. Patients diagnosed with AHRF were extracted from the MIMIC-IV database and divided into four groups based on the ROX index quartiles. The primary outcome was 28-day mortality, while in-hospital mortality and follow-up mortality were secondary outcomes. To investigate the association between ROX index and mortality in AHRF patients, restricted cubic spline curve and COX proportional risk regression were utilized. A non-linear association (L-shaped) has been observed between the ROX index and mortality rate. When the ROX index is below 8.28, there is a notable decline in the 28-day mortality risk of patients as the ROX index increases (HR per SD, 0.858 [95%CI 0.794-0.928] P &lt; 0.001). When the ROX index is above 8.28, no significant association was found between the ROX index and 28-day mortality. In contrast to the Q1 group, the mortality rates in the Q2, Q3, and Q4 groups had a substantial reduction (Q1 vs. Q2: HR, 0.749 [0.590-0.950] P = 0.017; Q3: HR, 0.711 [0.558-0.906] P = 0.006; Q4: HR, 0.641 [0.495-0.830] P &lt; 0.001). 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The Author(s).</rights><rights>COPYRIGHT 2024 BioMed Central Ltd.</rights><rights>2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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Therefore, a retrospective cohort study was conducted to evaluate the ability of the ROX index to predict mortality risk in patients with AHRF. Patients diagnosed with AHRF were extracted from the MIMIC-IV database and divided into four groups based on the ROX index quartiles. The primary outcome was 28-day mortality, while in-hospital mortality and follow-up mortality were secondary outcomes. To investigate the association between ROX index and mortality in AHRF patients, restricted cubic spline curve and COX proportional risk regression were utilized. A non-linear association (L-shaped) has been observed between the ROX index and mortality rate. When the ROX index is below 8.28, there is a notable decline in the 28-day mortality risk of patients as the ROX index increases (HR per SD, 0.858 [95%CI 0.794-0.928] P &lt; 0.001). When the ROX index is above 8.28, no significant association was found between the ROX index and 28-day mortality. 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Therefore, a retrospective cohort study was conducted to evaluate the ability of the ROX index to predict mortality risk in patients with AHRF. Patients diagnosed with AHRF were extracted from the MIMIC-IV database and divided into four groups based on the ROX index quartiles. The primary outcome was 28-day mortality, while in-hospital mortality and follow-up mortality were secondary outcomes. To investigate the association between ROX index and mortality in AHRF patients, restricted cubic spline curve and COX proportional risk regression were utilized. A non-linear association (L-shaped) has been observed between the ROX index and mortality rate. When the ROX index is below 8.28, there is a notable decline in the 28-day mortality risk of patients as the ROX index increases (HR per SD, 0.858 [95%CI 0.794-0.928] P &lt; 0.001). When the ROX index is above 8.28, no significant association was found between the ROX index and 28-day mortality. In contrast to the Q1 group, the mortality rates in the Q2, Q3, and Q4 groups had a substantial reduction (Q1 vs. Q2: HR, 0.749 [0.590-0.950] P = 0.017; Q3: HR, 0.711 [0.558-0.906] P = 0.006; Q4: HR, 0.641 [0.495-0.830] P &lt; 0.001). The ROX index serves as a valuable predictor of mortality risk in adult patients with AHRF, and that a lower ROX index is substantially associated with an increase in mortality.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>38553757</pmid><doi>10.1186/s12931-024-02771-9</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects Acute hypoxemic respiratory failure
Biological markers
Care and treatment
Cerebrovascular disease
Creatinine
Diagnosis
Evaluation
Extracorporeal membrane oxygenation
Gender
Health risks
Hospitalization
Hospitals
Hypotheses
Liver diseases
MIMIC-IV
Missing data
Mortality
Mortality risk
Oxygen saturation
Patients
Potassium
Prognosis
Respiratory failure
Respiratory insufficiency
Risk
ROX index
Spline functions
Statistical analysis
Structured Query Language-SQL
Survival analysis
Variables
Ventilators
title Association between the ROX index and mortality in patients with acute hypoxemic respiratory failure: a retrospective cohort study
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