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The patients were assigned to the treatment group or control group according to whether they were receiving HFNC or non-invasive ventilation (NIV) after extubation. The 28-day mortality and 28-day reintubation rates were compared between the two groups after Propensity score matching (PSM). The predictor for reintubation was formulated according to the risk factors with the XGBoost algorithm. The areas under the receiver operating characteristic curve (AUC) was calculated for reintubation prediction according to values at 4\u00a0h after extubation, which was compared with the ratio of SpO\n                      <jats:sub>2<\/jats:sub>\n                      \/FiO\n                      <jats:sub>2<\/jats:sub>\n                      to respiratory rate (ROX index).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 524,520 medical\u00a0records were screened, and 801 patients with moderate or severe hypoxemia when undergoing mechanical ventilation weaning were included (100\u2009&lt;\u2009PaO2\/FiO2\u2009\u2264\u2009300\u00a0mmHg), including 358 patients who received HFNC therapy after extubation in the treatment group. There were 315 patients with severe hypoxemia (100\u2009&lt;\u2009PaO2\/FiO2\u2009\u2264\u2009200\u00a0mmHg) before extubation, and 190 patients remained in the treatment group with median oxygenation index 166[157,180] mmHg after PSM. There were no significant differences in the 28-day reintubation rate or 28-day mortality between the two groups with moderate or severe hypoxemia (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.05). Then HR\/SpO\n                      <jats:sub>2<\/jats:sub>\n                      was formulated as a predictor for 48-h reintubation according to the important features predicting weaning failure. According to values at 4\u00a0h after extubation, the AUC of HR\/SpO\n                      <jats:sub>2<\/jats:sub>\n                      was 0.657, which was larger than that of ROX index (0.583). When the HR\/SpO\n                      <jats:sub>2<\/jats:sub>\n                      reached 1.2 at 4\u00a0h after extubation, the specificity for 48-h reintubation prediction was 93%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The treatment effect of HFNC therapy is not inferior to that of NIV, even on patients with oxygenation index from 160 to 180\u00a0mmHg when weaning from ventilator. HR\/SpO\n                      <jats:sub>2<\/jats:sub>\n                      is more early and accurate in predicting HFNC failure than ROX index.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-021-01526-2","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T14:03:03Z","timestamp":1620914583000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Effects of high-flow oxygen therapy on patients with hypoxemia after extubation and predictors of reintubation: a retrospective study based on the MIMIC-IV database"],"prefix":"10.1186","volume":"21","author":[{"given":"Taotao","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyu","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6237-2895","authenticated-orcid":false,"given":"Bin","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,13]]},"reference":[{"key":"1526_CR1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s40560-015-0084-5","volume":"3","author":"M Nishimura","year":"2015","unstructured":"Nishimura M. 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