HOPE provdes 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).



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.

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.

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