Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarming
Abstract Background We studied adult hypothermic cardiac arrest (CA) patients admitted to a University Hospital (UH) and a Regional Hospital (RH) for whom Extracorporeal Life Support (ECLS) was implemented. We used the HOPE score to estimate individual survival probabilities and to compare overall r...
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BMC
2025-07-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s13049-025-01445-9 |
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| author | Nicolas Hall Jessika Métrailler-Mermoud Valentin Rousson Chloé Conforti Amélie Dupasquier Pierre-Nicolas Carron Silke Grabherr Bettina Schrag Matthias Kirsch Cheyenne Falat Dominique Delay Vincent Frochaux Mathieu Pasquier |
| author_facet | Nicolas Hall Jessika Métrailler-Mermoud Valentin Rousson Chloé Conforti Amélie Dupasquier Pierre-Nicolas Carron Silke Grabherr Bettina Schrag Matthias Kirsch Cheyenne Falat Dominique Delay Vincent Frochaux Mathieu Pasquier |
| author_sort | Nicolas Hall |
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| description | Abstract Background We studied adult hypothermic cardiac arrest (CA) patients admitted to a University Hospital (UH) and a Regional Hospital (RH) for whom Extracorporeal Life Support (ECLS) was implemented. We used the HOPE score to estimate individual survival probabilities and to compare overall results between hospitals. Methods We included hypothermic CA patients who underwent ECLS between 2000 and 2022. We assessed the predicted survival probabilities by calculating the HOPE scores, both at individual and hospital levels. We assessed the performance of a HOPE score cutoff of 10% in predicting survival to hospital discharge, as ECLS rewarming is currently recommended when the HOPE is ≥ 10%. We also assessed the utility of the HOPE score in evaluating and comparing patient management within and between two hospitals. Results In the 46 patients with successful ECLS implementation, a HOPE score < 10% would have contraindicated and therefore prevented futile ECLS rewarming procedures for 17 patients (37%) who did not survive, while finding that ECLS was indicated for 100% of survivors. The observed survival rate was 24% (UH: 35%, RH: 11%) whereas the HOPE score predicted a survival rate of 35% (UH: 41%, RH: 26%), suggesting underperformance of ECLS rewarming among both hospitals. The difference of survival between the two hospitals was not statistically significant. Conclusions This study confirmed the utility of the HOPE score in estimating individual survival probabilities. The HOPE score may also be used to estimate the overall survival rate in a patient cohort, enabling internal quality-control and outcome results comparisons between different settings. |
| format | Article |
| id | doaj-art-8b22de19f4d44c50ade841e9ba29f36a |
| institution | Kabale University |
| issn | 1757-7241 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj-art-8b22de19f4d44c50ade841e9ba29f36a2025-08-20T03:46:16ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-07-013311910.1186/s13049-025-01445-9Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarmingNicolas Hall0Jessika Métrailler-Mermoud1Valentin Rousson2Chloé Conforti3Amélie Dupasquier4Pierre-Nicolas Carron5Silke Grabherr6Bettina Schrag7Matthias Kirsch8Cheyenne Falat9Dominique Delay10Vincent Frochaux11Mathieu Pasquier12Department of Emergency Medicine, Lausanne University Hospital and University of LausanneEmergency Service, Valais HospitalCenter for Primary Care and Public Health (Unisanté)Lausanne University School of MedicineLausanne University School of MedicineDepartment of Emergency Medicine, Lausanne University Hospital and University of LausanneUniversity Center of Legal Medicine, Lausanne - Geneva, Lausanne University Hospital and University of Lausanne, Geneva University Hospital and University of GenevaLegal Medicine Service, Hospitals Central Institute (ICH)Department of Cardiac Surgery, Lausanne University HospitalDepartment of Emergency Medicine, University of Maryland School of MedicineDepartment of Cardiac Surgery, Valais HospitalEmergency Service, Valais HospitalDepartment of Emergency Medicine, Lausanne University Hospital and University of LausanneAbstract Background We studied adult hypothermic cardiac arrest (CA) patients admitted to a University Hospital (UH) and a Regional Hospital (RH) for whom Extracorporeal Life Support (ECLS) was implemented. We used the HOPE score to estimate individual survival probabilities and to compare overall results between hospitals. Methods We included hypothermic CA patients who underwent ECLS between 2000 and 2022. We assessed the predicted survival probabilities by calculating the HOPE scores, both at individual and hospital levels. We assessed the performance of a HOPE score cutoff of 10% in predicting survival to hospital discharge, as ECLS rewarming is currently recommended when the HOPE is ≥ 10%. We also assessed the utility of the HOPE score in evaluating and comparing patient management within and between two hospitals. Results In the 46 patients with successful ECLS implementation, a HOPE score < 10% would have contraindicated and therefore prevented futile ECLS rewarming procedures for 17 patients (37%) who did not survive, while finding that ECLS was indicated for 100% of survivors. The observed survival rate was 24% (UH: 35%, RH: 11%) whereas the HOPE score predicted a survival rate of 35% (UH: 41%, RH: 26%), suggesting underperformance of ECLS rewarming among both hospitals. The difference of survival between the two hospitals was not statistically significant. Conclusions This study confirmed the utility of the HOPE score in estimating individual survival probabilities. The HOPE score may also be used to estimate the overall survival rate in a patient cohort, enabling internal quality-control and outcome results comparisons between different settings.https://doi.org/10.1186/s13049-025-01445-9Accidental hypothermiaCardiac arrestECLSEnvironmental hypothermiaHOPE scoreBenchmarking |
| spellingShingle | Nicolas Hall Jessika Métrailler-Mermoud Valentin Rousson Chloé Conforti Amélie Dupasquier Pierre-Nicolas Carron Silke Grabherr Bettina Schrag Matthias Kirsch Cheyenne Falat Dominique Delay Vincent Frochaux Mathieu Pasquier Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarming Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Accidental hypothermia Cardiac arrest ECLS Environmental hypothermia HOPE score Benchmarking |
| title | Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarming |
| title_full | Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarming |
| title_fullStr | Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarming |
| title_full_unstemmed | Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarming |
| title_short | Use of the HOPE score to assess survival outcome of hypothermic cardiac arrest selected by ECLS rewarming |
| title_sort | use of the hope score to assess survival outcome of hypothermic cardiac arrest selected by ecls rewarming |
| topic | Accidental hypothermia Cardiac arrest ECLS Environmental hypothermia HOPE score Benchmarking |
| url | https://doi.org/10.1186/s13049-025-01445-9 |
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