Hall Nicolas, Métrailler-Mermoud Jessika, Rousson Valentin, Conforti Chloé, Dupasquier Amélie, Carron Pierre-Nicolas, Grabherr Silke, Schrag Bettina, Kirsch Matthias, Falat Cheyenne, Delay Dominique, Frochaux Vincent, Pasquier Mathieu
Department of Emergency Medicine, Lausanne University Hospital and University of Lausanne, BH09, 1011, Lausanne, Switzerland.
Emergency Service, Valais Hospital, 1951, Sion, Switzerland.
Scand J Trauma Resusc Emerg Med. 2025 Jul 28;33(1):132. doi: 10.1186/s13049-025-01445-9.
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.
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.
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.
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.
我们研究了入住大学医院（UH）和地区医院（RH）并接受体外生命支持（ECLS）的成年低温性心脏骤停（CA）患者。我们使用HOPE评分来估计个体生存概率，并比较两家医院的总体结果。
我们纳入了2000年至2022年间接受ECLS的低温性CA患者。我们通过计算个体和医院层面的HOPE评分来评估预测的生存概率。我们评估了HOPE评分临界值为10%在预测出院生存方面的表现，因为目前当HOPE≥10%时推荐进行ECLS复温。我们还评估了HOPE评分在评估和比较两家医院内部及之间患者管理方面的效用。
在46例成功实施ECLS的患者中，HOPE评分<10%会表明17例（37%）未存活患者进行ECLS复温是禁忌的，因此可避免无效的ECLS复温程序，同时发现100%的存活者适合进行ECLS。观察到的生存率为24%（大学医院：35%，地区医院：11%），而HOPE评分预测的生存率为35%（大学医院：41%，地区医院：26%），这表明两家医院的ECLS复温效果均欠佳。两家医院之间的生存差异无统计学意义。
本研究证实了HOPE评分在估计个体生存概率方面的效用。HOPE评分还可用于估计患者队列的总体生存率，有助于进行内部质量控制以及不同环境之间的结果比较。
