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Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score.

Abstract：

AIMS:Currently, the decision to initiate extracorporeal life support for patients who suffer cardiac arrest due to accidental hypothermia is essentially based on serum potassium level. Our goal was to build a prediction score in order to determine the probability of survival following rewarming of hypothermic arrested patients based on several covariates available at admission. METHODS:We included consecutive hypothermic arrested patients who underwent rewarming with extracorporeal life support. The sample comprised 237 patients identified through the literature from 18 studies, and 49 additional patients obtained from hospital data collection. We considered nine potential predictors of survival: age; sex; core temperature; serum potassium level; mechanism of hypothermia; cardiac rhythm at admission; witnessed cardiac arrest, rewarming method and cardiopulmonary resuscitation duration prior to the initiation of extracorporeal life support. The primary outcome parameter was survival to hospital discharge. RESULTS:Overall, 106 of the 286 included patients survived (37%; 95% CI: 32-43%), most (84%) with a good neurological outcome. The final score included the following variables: age, sex, core temperature at admission, serum potassium level, mechanism of cooling, and cardiopulmonary resuscitation duration. The corresponding area under the receiver operating characteristic curve was 0.895 (95% CI: 0.859-0.931) compared to 0.774 (95% CI: 0.720-0.828) when based on serum potassium level alone. CONCLUSIONS:In this large retrospective study we found that our score was superior to dichotomous triage based on serum potassium level in assessing which hypothermic patients in cardiac arrest would benefit from extracorporeal life support. External validation of our findings is required.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Pasquier M,Hugli O,Paal P,Darocha T,Blancher M,Husby P,Silfvast T,Carron PN,Rousson V

doi

10.1016/j.resuscitation.2018.02.026

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

58-64

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(18)30094-7

journal_volume

126

pub_type

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Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score.