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Noninvasive Ventilation Outcomes (NIVO) score
Predicts in-hospital mortality in COPD exacerbations requiring noninvasive ventilation.
Noninvasive Ventilation Outcomes (NIVO) score
Extended MRC Dyspnoea (eMRCD)
5a = too breathless to leave the house but independent in washing/dressing; 5b = also dependent for washing/dressing.
Time from admission to acidaemia >12 h
pH <7.25
Atrial fibrillation
Glasgow Coma Scale ≤14
Chest radiograph consolidation
Result0 points
Low risk — in-hospital mortality about 5%.
- Risk group mortality
- in-hospital mortality about 5%.
When to use
- Prognostication at the onset of NIV for an acute hypercapnic COPD exacerbation.
- Supporting shared decisions about ceiling of care and escalation planning.
Formula
One point each for eMRCD 5a, time to acidaemia >12 h, pH <7.25, atrial fibrillation, GCS ≤14, and CXR consolidation; eMRCD 5b scores 2 (5a and 5b are mutually exclusive). Range 0–9.
Pearls and pitfalls
- Derived and validated specifically in COPD patients receiving assisted ventilation, not general respiratory failure.
- A high score flags poor prognosis but should complement, not replace, clinical judgement about escalation.