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

Détails

ID Serval
serval:BIB_D112298D1012
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score.
Périodique
Resuscitation
Auteur(s)
Pasquier M., Hugli O., Paal P., Darocha T., Blancher M., Husby P., Silfvast T., Carron P.N., Rousson V.
ISSN
1873-1570 (Electronic)
ISSN-L
0300-9572
Statut éditorial
Publié
Date de publication
05/2018
Peer-reviewed
Oui
Volume
126
Pages
58-64
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
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.
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.
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.
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.
Mots-clé
Adolescent, Adult, Cardiopulmonary Resuscitation/statistics & numerical data, Clinical Decision-Making, Extracorporeal Membrane Oxygenation/methods, Extracorporeal Membrane Oxygenation/mortality, Humans, Hypothermia/blood, Hypothermia/complications, Hypothermia/mortality, Hypothermia/therapy, Male, Middle Aged, Out-of-Hospital Cardiac Arrest/etiology, Out-of-Hospital Cardiac Arrest/mortality, Out-of-Hospital Cardiac Arrest/therapy, Potassium/blood, Predictive Value of Tests, Retrospective Studies, Rewarming/methods, Treatment Outcome, Young Adult, Accidental, Cardiac arrest, ECMO, ECPR, Hypothermia, Potassium, Resuscitation, Triage
Pubmed
Web of science
Création de la notice
03/03/2018 15:24
Dernière modification de la notice
20/08/2019 16:51
Données d'usage