nivo_score: NIVO Score for COPD Exacerbation

In cliot: Clinical Indices and Outcomes Tools

NIVO Score for COPD Exacerbation

Description

Calculates the Non-invasive Ventilation Outcomes (NIVO) score to predict in-hospital mortality in patients hospitalized with an acute exacerbation of COPD requiring non-invasive ventilation (NIV). The score is derived from the eMRCD dyspnea score, acidemia, chest radiograph findings, GCS, and presence of atrial fibrillation.

Usage

nivo_score(emrcd_score, arterial_ph, consolidation_cxr, gcs_score,
           atrial_fibrillation)

Arguments

emrcd_score	String. Extended MRC Dyspnea Score. "1_4": Not housebound (0 points). "5a": Housebound but independent washing/dressing (2 points). "5b": Housebound and dependent for washing/dressing (4 points).
arterial_ph	Numeric. Arterial pH at initiation of NIV. (< 7.25 adds 2 points).
consolidation_cxr	Numeric (0 or 1). Presence of consolidation on Chest X-ray. (1 = Yes, +2 points).
gcs_score	Numeric. Glasgow Coma Scale score. (< 15 adds 2 points).
atrial_fibrillation	Numeric (0 or 1). Presence of Atrial Fibrillation (history or new). (1 = Yes, +1 point).

Value

A list containing:

NIVO_Score	The calculated total score (Range 0-11).
Risk_Category	Risk classification (Low to Highest).
In_Hospital_Mortality	Estimated in-hospital mortality percentage.

References

Hartley T, Lane ND, Steer J, et al. Predicting in-hospital mortality in patients with acute exacerbations of chronic obstructive pulmonary disease requiring non-invasive ventilation: the NIVO score. Thorax. 2021;76(8):777-783. doi:10.1136/thoraxjnl-2020-215841

Examples

# Example 1: High Risk
# eMRCD 5b (4), pH 7.20 (2), No consolidation, GCS 15, No AF
# Score = 4 + 2 = 6
nivo_score("5b", 7.20, 0, 15, 0)

# Example 2: Low Risk
# eMRCD 1-4 (0), pH 7.30 (0), No consolidation, GCS 15, No AF
# Score = 0
nivo_score("1_4", 7.30, 0, 15, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.