The Cardiovascular
ToolsCalculators

HACOR Score

Predicts failure of non-invasive ventilation in hypoxaemic respiratory failure.

HACOR Score
Heart rate
Arterial pH
Glasgow Coma Scale
PaO2/FiO2 ratio
Respiratory rate
Result0 points

Low risk of NIV failure with continued non-invasive ventilation.

Cutoff
<=5 points

When to use

  • Reassessing patients with hypoxaemic acute respiratory failure on non-invasive ventilation (e.g. at 1, 12, 24, 48 hours) to decide on escalation to intubation.

Formula

Sum of points for heart rate, acidosis (pH), consciousness (GCS), oxygenation (PaO2/FiO2), and respiratory rate (maximum 25 points). Score >5, most validated at 1 hour of NIV, predicts NIV failure.

Pearls and pitfalls

  • In patients failing NIV with a score >5 at 1 hour, earlier intubation (<=12 hours) was associated with lower hospital mortality than delayed intubation.

References

  1. Duan J, Han X, Bai L, Zhou L, Huang S. Intensive Care Med. 2017;43(2):192-9.