Background and Aim: Mortality and morbidity increase with acute hypercapnic respiratory failure during COPD exacerbation. Due to the lack of adequate prognostic scoring systems for assessing mortality in patients with acute hypercapnic respiratory failure during COPD exacerbation, Hartley et al. designed an easy-to-use score named NIVO. We aimed to assess the efficacy of the NIVO score as a predictor of in-hospital and late mortality in COPD patients with acute hypercapnic respiratory failure.

Methods: This retrospective cross-sectional study was performed in a tertiary research and training hospital for chest diseases from November 2019 to November 2021 and patients with COPD who were hospitalized with exacerbation requiring assisted ventilation were included. The patients’ demographic characteristics, laboratory and clinical data were collected from the hospital database. Patients were classified according to NIVO score. In –hospital and late mortality rate were recorded.

Results: The study included 250 COPD patients with acute hypercapnic respiratory failure. The majority of patients (42%) classified according to the NIVO score were in the moderate risk group. The intubation rate due to NIMV failure in the high-risk group based on the NIVO score was 38.8% while the rates in the moderate and low-risk groups were 9.5%, 8%, respectively. The high-risk group had a significantly greater risk for intubation than did the moderate- and low-risk groups (p<0.001). Increased risk levels in accordance with NIVO score was associated with significantly greater in-hospital and late mortality (p<0.001).
Conclusions: The novel and easy-to-use NIVO score is important for predicting the prognosis of COPD patients with exacerbation requiring assisted ventilation.