Early Measurement of ROX Index in Intermediary Care Unit Is Associated with Mortality in Intubated COVID‐19 Patients: A Retrospective Study

Abstract

COVID‐19 patients often present with rapidly progressing acute hypoxemic respiratory failure, requiring orotracheal intubation with different prognostic issues. However, ICU specialists lack predictive tools to stratify these patients. We conducted a single‐center cross‐sectional retrospective study to evaluate if the ROX index, measured under non‐invasive oxygenation support, can predict ICU mortality in a COVID‐19 intubated patient cohort. This study took place in the division of intensive care at the Geneva University Hospitals (Geneva, Switzerland). We included all consecutive adult patients treated by non‐invasive oxygenation support and requiring intubation for acute respiratory failure due to COVID‐19 between 9 September 2020 and 30 March 2021, corresponding to the second local surge of COVID‐19 cases. Baseline demographic data, comorbidities, median ROX between H0 and H8, and clinical outcomes were collected. Overall, 82 patients were intubated after failing a non‐invasive oxygenation procedure. Women represented 25.6% of the whole cohort. Median age and median BMI were 70 (60–75) years and 28 (25–33), respectively. Before intubation, the median ROX between H0 and H8 was 6.3 (5.0–8.2). In a multivariate analysis, the median ROX H0–H8 was associated with ICU mortality as a protective factor with an odds ratio (95% CI) = 0.77 (0.60–0.99); p < 0.05. In intubated COVID‐19 patients treated initially by non‐invasive oxygenation support for acute respiratory failure, the median ROX H0–H8 could be an interesting predictive factor associated with ICU mortality.