% 0期刊文章%哈特利,汤姆%巷,尼古拉斯·d·%引导,约翰%艾略特,马克·w·% Sovani, Milind柯蒂斯p . %,海伦简%更全面,伊丽莎白·r·墨菲%,帕特里克·b·% Shrikrishna, Dinesh %的刘易斯,Keir e %病房,尼尔·r·%特恩布尔,克里斯·d·哈特%,尼古拉斯·伯克%,无创通气结果(NIVO)评分:预测需要辅助通气的COPD急性加重(AECOPD)合并急性(酸性)高碳酸血症呼吸衰竭(AHRF)的住院死亡率是常见的。如果使用得当，通气可以显著降低死亡率。尽管如此，仍有证据表明缺乏实践和悲观预测。临床预测工具可以改善有关通气的决策，但没有常规使用。方法在两家不同人群的医院中连续收治AECOPD和AHRF患者，采用辅助通气(主要是无创通气)治疗。已知的和潜在的预后指标是预先确定的。采用多元回归分析方法，建立住院死亡预测工具。前瞻性外部验证是在一个时间上独立的，地理上不同的10个中心的研究中进行的。 The trial methodology adhered to TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) recommendations.Results Derivation cohort: n=489, in-hospital mortality 25.4%; validation cohort: n=733, in-hospital mortality 20.1%. Using six simple categorised variables (extended Medical Research Council Dyspnoea score 1–4/5a/5b, time from admission to acidaemia >12 h, pH <7.25, presence of atrial fibrillation, Glasgow coma scale ≤14 and chest radiograph consolidation), a simple scoring system with strong prediction of in-hospital mortality is achieved. The resultant Noninvasive Ventilation Outcomes (NIVO) score had area under the receiver operating curve of 0.79 and offers good calibration and discrimination across stratified risk groups in its validation cohort.Discussion The NIVO score outperformed pre-specified comparator scores. It is validated in a generalisable cohort and works despite the heterogeneity inherent to both this patient group and this intervention. Potential applications include informing discussions with patients and their families, aiding treatment escalation decisions, challenging pessimism and comparing risk-adjusted outcomes across centres.The NIVO score was created to predict in-hospital mortality in exacerbations of COPD requiring assisted ventilation. Prospective validation under real-world conditions in 10 UK hospitals shows it easily outperforms existing alternative scores. https://bit.ly/3oKMZdI %U //www.qdcxjkg.com/content/erj/58/2/2004042.full.pdf