ROX Index to Predict Risk of Intubation

Predict risk of intubation at 2, 6 and 12 hours in hypoxemic respiratory failure. Not yet validated for COVID-19

The global unit selector only affects unanswered questions
3.Respiratory Rate
Created by

1. SpO₂

More Information

SpO₂ represents peripheral capillary oxygen saturation

Created by
0/3 completed

About this Calculator

During high-flow nasal cannula (HFNC) therapy in patients with acute hypoxemic respiratory failure, it can be desirable not to delay intubation and have an adverse event.

The ROX index, defined as the ratio of oxygen saturation as measured by pulse oximetry/FIO2 to respiratory rate, has been assessed as a predictor of the need to intubate in patients received HFNC oxygen therapy.

Prediction accuracy of the ROX index increased over time with AUC of 0.679 at 2 h, 0.703 at 6 hours and 0.759 at 12 hours.

ROX &ge:4.88 at 2, 6 and 12 hours after HFNC initiation was associated with a lower risk for intubation.

Predictors of HFNC failure include:

  • ROX <:2.85 at 2 hours
  • ROX <:3.47 at 6 hours
  • ROX <:3.85 at 12 hours


Roca O et al.

An Index Combining Respiratory Rate and Oxygenation to Predict Outcome of Nasal High-Flow Therapy.

American Journal of Respiratory and Critical Care Medicine 2019 June 1, 199 (11): 1368-1376.

Legal Notices and Disclaimer

© 2020 QxMD Software Inc., all rights reserved. No part of this service may be reproduced in any way without express written consent of QxMD. This information should not be used for the diagnosis or treatment of any health problem or disease. This information is not intended to replace clinical judgment or guide individual patient care in any manner. Click here for full notice and disclaimer.