Materiały źródłowe

• #1 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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8622062/

  Aims: 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 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%. […] 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. […] The average of the HOPE survival probabilities was 54%, which is well and significantly below the observed proportion of 89% of survivors.

• #1 Accidental Hypothermia: 2021 Update

  https://www.mdpi.com/1660-4601/19/1/501

  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 […] In hypothermic patients, the chances of survival and good neurological outcome are higher than for normothermic patients for witnessed, unwitnessed, and asystolic cardiac arrest. […] The in-hospital HOPE score has substantially improved outcome prediction for hypothermic patients in cardiac arrest who are treated with ECLS rewarming. […] The Hypothermia Outcome Prediction after Extracorporeal Life Support (HOPE) score is currently the best available prediction tool and should be used to evaluate whether a hypothermic patient in cardiac arrest is likely to benefit from ECLS rewarming.

• #1 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

  https://www.mdpi.com/1660-4601/18/22/11896

  Aims: 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 HOPE score provides an estimate of the probability of in-hospital survival of a given CA patient with accidental hypothermia after ECLS rewarming, based on six covariates available at hospital admission, which are age, sex, mechanism of hypothermia, core temperature (if not available, prehospital temperature), serum potassium value, and cardiopulmonary resuscitation (CPR) duration (defined as the time from initiation of CPR to the start of ECLS). […] The HOPE score has been externally validated in another (different) sample of 122 patients, which confirmed its good calibration and good discrimination.

• #1 HOPE – Survival probability

  https://www.hypothermiascore.org/

  HOPE provides a prediction of the survival probability in hypothermic cardiac arrest patients undergoing Extra-Corporeal Life Support (ECLS) rewarming. […] The survival probabilities range from 0% to 100% chance of survival to hospital discharge. […] A cutoff of 10% to decide which hypothermic patients in cardiac arrest would benefit or not from ECLS rewarming was evaluated in an external validation study. […] The negative predictive value of a HOPE probability 10% was of 97%, and the AUC under the ROC curve was of 0.825 which suggest excellent discrimination. […] Hypothermia should be considered as a likely cause of CA for an avalanche victim buried 60 minutes and with a witnessed CA. […] If there is a possibility that an avalanche victim may not have been asphyxiated despite full burial, calculating the HOPE score using the non-asphyxia scenario will decrease the risk of underestimating the probability of survival after rewarming. […] The HOPE survival probability is :

• #1 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

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8622062/

  The positive predictive value in the present study was high (92% compared to less than 60% in the HOPE derivation and validation studies) due to the over-representation of survivors in case reports. […] The survival rate in the present study was 89%, which is much higher than in the HOPE derivation (37%) and validation (42%) studies, which included only consecutive cases. […] All but one of the survivors had a HOPE-estimated survival probability higher than 10%. […] In this highly selected sample, the HOPE score still had a good practical performance in terms of discrimination, false positives, and false negatives rates.

• #1

  https://link.springer.com/article/10.1007/s11739-024-03741-1

  Hemodynamically unstable patients with severe hypothermia and preserved circulation should be transported to dedicated extracorporeal life support (ECLS) centers, but not all are eligible for extracorporeal therapy. […] The aim of this study is to identify pre-rewarming predictors of death and their threshold values in hypothermic patients with core temperature28 C and preserved circulation, who were treated without extracorporeal rewarming. […] In the multivariate analysis of laboratory tests and vital signs, systolic blood pressure (SBP) adjusted for cooling circumstances and base excess (BE) were identified as the best predictor of death (OR 0.974 95% CI 0.9520.996), AUC ROC 0.79 (0.700.88). […] The clinically relevant cutoff for SBP was identified at 90 mmHg with a sensitivity of 0.74 (0.540.89) and a specificity of 0.70 (0.600.79).

• #1 A novel scoring system for predicting the neurologic prognosis prior to the initiation of induced hypothermia in cases of post-cardiac arrest syndrome: the CAST score | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Full Text

  https://sjtrem.biomedcentral.com/articles/10.1186/s13049-017-0392-y

  The aim of this study was to develop a scoring system for identifying the post-cardiac arrest syndrome (PCAS) patients with a good potential for recovery prior to the initiation of induced therapeutic hypothermia. […] Finally, using all the data, we established a post-Cardiac Arrest Syndrome for induced Therapeutic hypothermia (CAST) score to predict the neurologic prognosis prior to initiation of induced hypothermia. […] The CAST score was developed to predict the neurological outcomes of PCAS patients treated by induced hypothermia. The likelihood of good recovery at 30 days was extremely low in PCAS patients with a CAST score of 15%. […] The aim of the present study was to develop a prognostic scoring system for predicting the neurologic prognosis in PCAS patients treated with induced hypothermia based on the results of examinations carried out prior to the initiation of induced hypothermia.

• #1

  https://journals.lww.com/md-journal/fulltext/2024/10040/early_prediction_of_intraoperative_hypothermia_in.48.aspx

  Intraoperative hypothermia is one of the most common adverse events related to surgery, and clinical practice has been severely underestimated. […] The intraoperative hypothermia prediction model based on machine learning has satisfactory predictive performance, especially in random forests. This interpretable prediction model helps doctors evaluate the risk of intraoperative hypothermia, optimize clinical decision-making, and improve patient prognosis. […] The hypothermia prediction model can serve as an early warning tool to provide medical staff with information on the risk of accidental hypothermia. […] Therefore, this study attempts to learn physiological measurement patterns before the onset of the disease and construct prediction models through multimodal machine learning algorithms, in order to predict intraoperative hypothermia earlier and assist in guiding clinical decision-making.

• #1 The prognostic value of gray-white-matter ratio in cardiac arrest patients treated with hypothermia | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Full Text

  https://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-21-23

  Mild therapeutic hypothermia alters the validity of a number of parameters currently used to predict neurological outcome after cardiac arrest and resuscitation. […] A GWR1.16 predicted poor outcome with 100% specificity and 38% sensitivity. […] Our results suggest a strong association of a low GWR with poor outcome following cardiac arrest. Determination of the GWR increases the sensitivity in a multi-parameter approach for prediction of poor outcome after cardiac arrest. […] Our study suggests that a gray-white matter ratio (GWR) below 1.16 may be a specific parameter for prediction of poor outcome in patients treated with hypothermia. […] None of 23 patients with a GWR1.16 survived with good outcome. […] However, GWR may be useful in a multi-parameter approach and may increase the certainty with which poor outcome can be predicted early after cardiac arrest in patients treated with hypothermia.

• #1 hypothermia | resusme

  https://resus.me/tag/hypothermia/

  In unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33C did not confer a benefit as compared with a targeted temperature of 36C. […] The beneficial effect of mild therapeutic hypothermia increases with cumulative time of complete circulatory standstill in patients with witnessed out-of-hospital cardiac arrest. […] Therapeutic hypothermia alters prognostic accuracy. […] A new multimodal approach to prognostication is therefore required, which may particularly improve early prediction of favorable clinical evolution after cardiac arrest.

• #1

  https://aesnet.org/abstractslisting/outcome-prediction-after-cardiac-arrest-treated-with-hypothermia

  Clinical and electrophysiological prognostic markers of brain anoxia have been mostly evaluated in comatose survivors of out hospital cardiac arrest (OHCA) after standard resuscitation, but their predictive value in patients treated with mild induced hypothermia (IH) is unknown. […] The objective of this study was to identify a predictive score of independent clinical and electrophysiological variables in comatose OHCA survivors treated with IH, aiming at a maximal positive predictive value (PPV) and a high negative predictive value (NPV) for mortality. […] A multivariable logistic regression was performed to identify independent predictors of mortality at hospital discharge. […] These were used to formulate a predictive score. […] We found a PPV of 1.00 (95% CI: 0.93-1.00), a NPV of 0.81 (95% CI: 0.67-0.91) and an accuracy of 0.93 for mortality.

• #1 hypothermia | resusme

  https://resus.me/tag/hypothermia/

  Many clinicians extrapolate adult research findings to paediatric patients because theres no alternative, and until now weve had to do that with post-cardiac arrest therapeutic hypothermia after paediatric cardiac arrest. […] Therapeutic hypothermia, as compared with therapeutic normothermia, did not confer a significant benefit with respect to survival with good functional outcome at 1 year, and survival at 12 months did not differ significantly between the treatment groups. […] In comatose children who survived out-of-hospital cardiac arrest, therapeutic hypothermia, as compared with therapeutic normothermia, did not confer a significant benefit in survival with a good functional outcome at 1 year. […] This latest study showed no difference in survival or neurological outcome after cardiac arrest between target temperatures of 33C and 36C.

• #1 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

  https://www.mdpi.com/1660-4601/18/22/11896

  The detection of all (or at least most) potentially surviving hypothermic CA patients is critical because of the good prognosis and neurological outcome in comparison with normothermic heart arrest. […] The HOPE score must be correlated with the clinical scenario. […] The most important limitation of this study is the low number of non-survivors and our subsequent low ability to draw conclusions about the negative predictive value of HOPE at a 10% cut-off value. […] In conclusion, our finding underscores the importance of working with a representative sample of patients when deriving and validating a score, and it supports the methodology used in HOPE studies that included only consecutive patients in order to minimize the risk of publication bias and lower the risk of overly optimistic outcomes.

• #2 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

  https://www.mdpi.com/1660-4601/18/22/11896

  Aims: 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 HOPE score provides an estimate of the probability of in-hospital survival of a given CA patient with accidental hypothermia after ECLS rewarming, based on six covariates available at hospital admission, which are age, sex, mechanism of hypothermia, core temperature (if not available, prehospital temperature), serum potassium value, and cardiopulmonary resuscitation (CPR) duration (defined as the time from initiation of CPR to the start of ECLS). […] The HOPE score has been externally validated in another (different) sample of 122 patients, which confirmed its good calibration and good discrimination.

• #2 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

  https://www.mdpi.com/1660-4601/18/22/11896

  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. […] The survival rate in the present study was 89%, which is much higher than in the HOPE derivation (37%) and validation (42%) studies, which included only consecutive cases. […] All but one of the survivors had a HOPE-estimated survival probability higher than 10%. […] The only false negative, i.e., the only patient who survived with a HOPE survival probability lower than 10%, was a 6-year-old boy with a HOPE survival probability of 9.92%. […] In this study, we evaluated the performance of the HOPE score on a sample of 70 non-consecutive patients who were described in case reports from the literature.

• #2 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

  https://www.mdpi.com/1660-4601/18/22/11896

  The detection of all (or at least most) potentially surviving hypothermic CA patients is critical because of the good prognosis and neurological outcome in comparison with normothermic heart arrest. […] The HOPE score must be correlated with the clinical scenario. […] The most important limitation of this study is the low number of non-survivors and our subsequent low ability to draw conclusions about the negative predictive value of HOPE at a 10% cut-off value. […] In conclusion, our finding underscores the importance of working with a representative sample of patients when deriving and validating a score, and it supports the methodology used in HOPE studies that included only consecutive patients in order to minimize the risk of publication bias and lower the risk of overly optimistic outcomes.

• #2

  https://link.springer.com/article/10.1007/s11739-024-03741-1

  The increased risk of death among hypothermic patients with preserved circulation occurs among those with an SBP below 90 mmHg and in those who developed hypothermia in their homes. […] Our study shows that among severely hypothermic, non-CA patients at high risk of death are those with systolic blood pressure90 mmHg and those who developed hypothermia in their homes. […] The results of our study may help to distinguish between stable patients, in whom non-invasive rewarming can be attempted, and unstable patients.

• #2 A novel scoring system for predicting the neurologic prognosis prior to the initiation of induced hypothermia in cases of post-cardiac arrest syndrome: the CAST score | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Full Text

  https://sjtrem.biomedcentral.com/articles/10.1186/s13049-017-0392-y

  The predictive accuracy of the CAST score is limited, because it was created using retrospective data, even though its generalizability is likely to be high, since it was developed using data from multiple centers. […] Prospective validation of the CAST score and a study to examine the usefulness of this score for predicting the long-term prognosis of PCAS patients are warranted.

• #2

  https://journals.lww.com/md-journal/fulltext/2024/10040/early_prediction_of_intraoperative_hypothermia_in.48.aspx

  In this study, we found that machine learning based predictive models may be beneficial for early identification and assisting in assessing potential risks of intraoperative hypothermia. […] Collectively, we have developed and validated 3 machine learning algorithms to help predict the risk of intraoperative hypothermia in advance. […] In summary, we have developed an interpretable intraoperative hypothermia warning model, particularly RFM, which has satisfactory predictive performance in estimating the risk of intraoperative hypothermia in patients. This can be used to improve the quality of temperature management in perioperative patients and improve their postoperative prognosis.

• #2

  https://aesnet.org/abstractslisting/outcome-prediction-after-cardiac-arrest-treated-with-hypothermia

  This simple score represents a promising tool to identify patients who will survive, and most subjects who will not, after OHCA and IH. […] The score appears robust even without SSEP, suggesting that SSEP and other investigations (e.g., mismatch negativity, serum NSE) might be principally needed to enhance prognostication in the small subgroup of patients failing to improve despite a favorable score.

• #2 hypothermia | resusme

  https://resus.me/tag/hypothermia/

  In unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33C did not confer a benefit as compared with a targeted temperature of 36C. […] The beneficial effect of mild therapeutic hypothermia increases with cumulative time of complete circulatory standstill in patients with witnessed out-of-hospital cardiac arrest. […] Therapeutic hypothermia alters prognostic accuracy. […] A new multimodal approach to prognostication is therefore required, which may particularly improve early prediction of favorable clinical evolution after cardiac arrest.

• #2 Accidental Hypothermia: 2021 Update

  https://www.mdpi.com/1660-4601/19/1/501

  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 […] In hypothermic patients, the chances of survival and good neurological outcome are higher than for normothermic patients for witnessed, unwitnessed, and asystolic cardiac arrest. […] The in-hospital HOPE score has substantially improved outcome prediction for hypothermic patients in cardiac arrest who are treated with ECLS rewarming. […] The Hypothermia Outcome Prediction after Extracorporeal Life Support (HOPE) score is currently the best available prediction tool and should be used to evaluate whether a hypothermic patient in cardiac arrest is likely to benefit from ECLS rewarming.

• #3 Accidental Hypothermia: 2021 Update

  https://www.mdpi.com/1660-4601/19/1/501

  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 […] In hypothermic patients, the chances of survival and good neurological outcome are higher than for normothermic patients for witnessed, unwitnessed, and asystolic cardiac arrest. […] The in-hospital HOPE score has substantially improved outcome prediction for hypothermic patients in cardiac arrest who are treated with ECLS rewarming. […] The Hypothermia Outcome Prediction after Extracorporeal Life Support (HOPE) score is currently the best available prediction tool and should be used to evaluate whether a hypothermic patient in cardiac arrest is likely to benefit from ECLS rewarming.

• #3 hypothermia | resusme

  https://resus.me/tag/hypothermia/

  In unconscious survivors of out-of-hospital cardiac arrest of presumed cardiac cause, hypothermia at a targeted temperature of 33C did not confer a benefit as compared with a targeted temperature of 36C. […] The beneficial effect of mild therapeutic hypothermia increases with cumulative time of complete circulatory standstill in patients with witnessed out-of-hospital cardiac arrest. […] Therapeutic hypothermia alters prognostic accuracy. […] A new multimodal approach to prognostication is therefore required, which may particularly improve early prediction of favorable clinical evolution after cardiac arrest.

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