HOPE - Survival probability

HOPE provides a prediction of the survival probability in hypothermic cardiac arrest patients undergoing Extra-Corporeal Life Support (ECLS) rewarming.

HOPE is the result of an international collaborative project initiated and led by the Emergency Department of the University Hospital of Lausanne, Switzerland. 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. Of note, one is of course free to use a different cut-off than the proposed threshold of 10% for different subgroups of the population (e.g. for children).

Hypothermia should be considered as a likely cause of CA for an avalanche victim buried > 60 minutes and with a witnessed CA. In this case, the HOPE score should be calculated using the non-asphyxia scenario. 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.

Estimates are desirable if variables are not known (e.g. age, CPR duration and temperature).

First name

Age (in years)

Sex Male Female

Hypothermia With asphyxia (head fully covered by water or snow) AND in cardiac arrest at extrication
Without asphyxia (immersion, outdoor or indoor cold exposure)

CPR duration (min)

Serum Potassium (mmol/L)

Temperature scale Celsius Fahrenheit

Temperature

HOPE survival probability

The HOPE survival probability is :

This calculator is not CE certified and is not FDA approved. HOPE is intended for educational and research purpose only, relative to the prediction of the probability of survival in hypothermic cardiac arrest patients undergoing ECLS rewarming. HOPE should not be used in clinical practice.

If you are using the HOPE survival probabilities to guide your decision about a real case, we would appreciate if you could give us your email address. We may contact you for additional information, specifically if ECLS was provided, and whether the patient survived or not.

By sending this form, you accept the transmission of the HOPE variables to the legal owner of the website. The data will be stored and processed in Switzerland for statistical purposes in order to administer the website, improve our services and further validate the HOPE performance.

For complementary information please read the following references:

HOPE derivation study: Pasquier M, Hugli O, Paal P, Darocha T, Blancher M, Husby P, Silfvast T, Carron PN, Rousson V. Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score. Resuscitation 2018.

HOPE external validation study: Pasquier M, Rousson V, Darocha T, Bouzat P, Kosiński S, Sawamoto K, Champigneulle B, Wiberg S, Wanscher M, Brodmann Maeder M, Hugli O. Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: An external validation of the HOPE Score. Resuscitation 2019.

ERC Guidelines 2021: Carsten L, et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation 2021.

ICAR guidelines 2023: Pasquier M, et al. On-site treatment of avalanche victims: 2023 recommendations of the ICAR MedCom. Resuscitation 2023.

Estimation of the survival probability using HOPE

HOPE provides a prediction of the survival probability in hypothermic cardiac arrest patients undergoing Extra-Corporeal Life Support (ECLS) rewarming.