Predictors of high-flow nasal cannula failure in COVID-19 patients in a northern Peruvian hospital

Objectives: To determine predictors of high-flow nasal cannula (HFNC) failure in COVID-19 patients in a hospital in northern Peru. Methodology: A retrospective cohort study was conducted during the months of March and May 2021. Data collection was based on a follow-up of 156 hospitalized patients with a diagnosis of COVID-19 who were users of HFNC. Epidemiological factors and clinical outcomes of treatment were analyzed from medical records. Epidemiological, analytical, and HFNC use-related characteristics were described using measures of absolute and relative frequencies, measures of central tendency, and dispersion. A multivariate Poisson regression analysis with robust variance and a 95% confidence interval was performed. Results: We found that age, SpO2/FiO2, work of breathing (WOB scale) at admission, degree of involvement, type of infiltrate on CT scan, lymphocytes, c-reactive protein, and D-dimer were significantly associated with failure of HFNC (p < 0.05). In addition, the WOB scale, PaO2/FiO2, SaO2/FiO2, and ROX index were variables that presented statistical significance (p < 0.0001). In the multivariate analysis model, a risk of failure of HFNC was determined with age > = 60 years [RRa 1.39 (1.05–1.85)] and PaO2/FiO2 score less than 100 [Rra 1.65 (0.99–2.76)]. Conclusions: Predictors to failure of HFNC are age older than 60 years and minimally significantly lower PaO2/FiO2 than 100.