Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature

<b>Aims</b>: The hypothermia outcome prediction after extracorporeal life support (ECLS) score, or HOPE score, provides an estimate of the survival probability in hypothermic cardiac arrest patients undergoing ECLS rewarming. The aim of this study was to assess the performance of the HOP...

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Autores principales:	Nolan Grin, Valentin Rousson, Tomasz Darocha, Olivier Hugli, Pierre-Nicolas Carron, Tobias Zingg, Mathieu Pasquier
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cardiac arrest ECMO ECPR hypothermia accidental potassium Medicine R
Acceso en línea:	https://doaj.org/article/de4986ad87a447eb800d15930011ef75
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spelling	oai:doaj.org-article:de4986ad87a447eb800d15930011ef752021-11-25T17:49:16ZHypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature10.3390/ijerph1822118961660-46011661-7827https://doaj.org/article/de4986ad87a447eb800d15930011ef752021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/22/11896https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601<b>Aims</b>: The hypothermia outcome prediction after extracorporeal life support (ECLS) score, or HOPE score, provides an estimate of the survival probability in hypothermic cardiac arrest patients undergoing ECLS rewarming. The aim of this study was to assess the performance of the HOPE score in case reports from the literature. <b>Methods</b>: Cases were identified through a systematic review of the literature. We included cases of hypothermic cardiac arrest patients rewarmed with ECLS and not included in the HOPE derivation and validation studies. We calculated the survival probability of each patient according to the HOPE score. <b>Results</b>: A total of 70 patients were included. Most of them (62/70 = 89%) survived. The discrimination using the HOPE score was good (Area Under the Receiver Operating Characteristic Curve = 0.78). The calibration was poor, with HOPE survival probabilities averaging 54%. Using a HOPE survival probability threshold of at least 10% as a decision criterion for rewarming a patient would have resulted in only five false positives and a single false negative, i.e., 64 (or 91%) correct decisions. <b>Conclusions</b>: In this highly selected sample, the HOPE score still had a good practical performance. The selection bias most likely explains the poor calibration found in the present study, with survivors being more often described in the literature than non-survivors. Our finding underscores the importance of working with a representative sample of patients when deriving and validating a score, as was the case in the HOPE studies that included only consecutive patients in order to minimize the risk of publication bias and lower the risk of overly optimistic outcomes.Nolan GrinValentin RoussonTomasz DarochaOlivier HugliPierre-Nicolas CarronTobias ZinggMathieu PasquierMDPI AGarticlecardiac arrestECMOECPRhypothermiaaccidentalpotassiumMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11896, p 11896 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiac arrest ECMO ECPR hypothermia accidental potassium Medicine R
spellingShingle	cardiac arrest ECMO ECPR hypothermia accidental potassium Medicine R Nolan Grin Valentin Rousson Tomasz Darocha Olivier Hugli Pierre-Nicolas Carron Tobias Zingg Mathieu Pasquier Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature
description	<b>Aims</b>: The hypothermia outcome prediction after extracorporeal life support (ECLS) score, or HOPE score, provides an estimate of the survival probability in hypothermic cardiac arrest patients undergoing ECLS rewarming. The aim of this study was to assess the performance of the HOPE score in case reports from the literature. <b>Methods</b>: Cases were identified through a systematic review of the literature. We included cases of hypothermic cardiac arrest patients rewarmed with ECLS and not included in the HOPE derivation and validation studies. We calculated the survival probability of each patient according to the HOPE score. <b>Results</b>: A total of 70 patients were included. Most of them (62/70 = 89%) survived. The discrimination using the HOPE score was good (Area Under the Receiver Operating Characteristic Curve = 0.78). The calibration was poor, with HOPE survival probabilities averaging 54%. Using a HOPE survival probability threshold of at least 10% as a decision criterion for rewarming a patient would have resulted in only five false positives and a single false negative, i.e., 64 (or 91%) correct decisions. <b>Conclusions</b>: In this highly selected sample, the HOPE score still had a good practical performance. The selection bias most likely explains the poor calibration found in the present study, with survivors being more often described in the literature than non-survivors. Our finding underscores the importance of working with a representative sample of patients when deriving and validating a score, as was the case in the HOPE studies that included only consecutive patients in order to minimize the risk of publication bias and lower the risk of overly optimistic outcomes.
format	article
author	Nolan Grin Valentin Rousson Tomasz Darocha Olivier Hugli Pierre-Nicolas Carron Tobias Zingg Mathieu Pasquier
author_facet	Nolan Grin Valentin Rousson Tomasz Darocha Olivier Hugli Pierre-Nicolas Carron Tobias Zingg Mathieu Pasquier
author_sort	Nolan Grin
title	Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature
title_short	Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature
title_full	Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature
title_fullStr	Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature
title_full_unstemmed	Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature
title_sort	hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: assessing the performance of the hope score in case reports from the literature
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/de4986ad87a447eb800d15930011ef75
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Hypothermia Outcome Prediction after Extracorporeal Life Support for Hypothermic Cardiac Arrest Patients: Assessing the Performance of the HOPE Score in Case Reports from the Literature

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