Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management

Ryoo, Seung Mok; Sohn, Chang Hwan; Kim, Won Young; Seo, Dong Woo; Kim, Youn-Jung

doi:10.3390/jcm9010159

Cited by 16 publications

(13 citation statements)

References 27 publications

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“…This retrospective, observational, registry-based cohort study was conducted at the emergency intensive care unit (ICU) of a tertiary care university-affiliated teaching hospital in Korea. Data were extracted from an OHCA registry, containing the prospectively collected data of consecutive adult patients (≥18 years) with OHCA since January 2010 [14,15]. The Institutional Review Board of the University of Ulsan College of Medicine reviewed and approved the study protocol (No.…”

Section: Study Design and Patientsmentioning

confidence: 99%

Background Frequency Patterns in Standard Electroencephalography as an Early Prognostic Tool in Out-of-Hospital Cardiac Arrest Survivors Treated with Targeted Temperature Management

Kim

Koo

et al. 2020

JCM

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We investigated the prognostic value of standard electroencephalography, a 30-min recording using 21 electrodes on the scalp, during the early post-cardiac arrest period, and evaluated the performance of electroencephalography findings combined with other clinical features for predicting favourable outcomes in comatose out-of-hospital cardiac arrest (OHCA) survivors treated with targeted temperature management (TTM). This observational registry-based study was conducted at a tertiary care hospital in Korea using the data of all consecutive adult non-traumatic comatose OHCA survivors who underwent standard electroencephalography during TTM between 2010 and 2018. The primary outcome was a 6-month favourable neurological outcome (Cerebral Performance Category score of 1 or 2). Among 170 comatose OHCA survivors with median electroencephalography time of 22 h, a 6-month favourable neurologic outcome was observed in 34.1% (58/170). After adjusting other clinical characteristics, an electroencephalography background with dominant alpha and theta waves had the highest odds ratio of 13.03 (95% confidence interval, 4.69–36.22) in multivariable logistic analysis. A combination of other clinical features (age < 65 years, initial shockable rhythm, resuscitation duration < 20 min) with an electroencephalography background with dominant alpha and theta waves increased predictive performance for favourable neurologic outcomes with a high specificity of up to 100%. A background with dominant alpha and theta waves in standard electroencephalography during TTM could be a simple and early favourable prognostic finding in comatose OHCA survivors.

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Section: Study Design and Patientsmentioning

confidence: 99%

Background Frequency Patterns in Standard Electroencephalography as an Early Prognostic Tool in Out-of-Hospital Cardiac Arrest Survivors Treated with Targeted Temperature Management

Kim

Koo

et al. 2020

JCM

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“…Third, the initial serum NSE level was measured within 24 hours of arrival at the hospital. The serum NSE level, measured to predict neurological prognosis in cardiac arrest patients, was reportedly highest at 48 hours after cardiac arrest [22,23]. Therefore, in our near-hanging patients, a stronger causal relationship between NSE and poor neurological outcome may have been found if multiple serial measurements had been conducted over the 48-hour post-injury period.…”

Section: Plos Onementioning

confidence: 81%

Neuron-specific enolase level as a predictor of neurological outcome in near-hanging patients: A retrospective multicenter study

Lee

Cho

et al. 2021

PLoS ONE

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Objectives Neuron-specific enolase (NSE) is frequently used to predict neurological outcomes in patients with hypoxic brain injury. Hanging can cause hypoxic brain damage, and survivors can suffer from neurological deficits that may impair daily activities. Here, we investigated the utility of the initial serum NSE level as a predictor of neurological outcomes in near-hanging patients with decreased consciousness. Methods This retrospective multicenter study was conducted in patients who visited the emergency department due to near-hanging injury from October 2013 to February 2019 at three university hospitals in Korea. They were divided into two groups according to the presence of out-of-hospital cardiac arrest. The neurological outcome was determined using the Cerebral Performance Category (CPC) measured at the time of discharge. Multivariate analysis was performed to determine whether initial serum NSE is an independent predictor of neurological outcome. Results Of the 70 patients included in the study, 44 showed a poor neurological outcome (CPC score = 3–5). Among the 52 patients with cardiac arrest, only 10 (19.2%) were discharged with good neurological outcome (CPC score = 1–2). In the whole cohort, a high serum NSE level was a significant predictor of poor neurological outcome (odds ratio [OR], 1.343; 95% confidence interval [CI], 1.003–1.800, p = 0.048). Among the patients with cardiac arrest, a high serum NSE level was a significant predictor of poor neurological outcome (OR, 1.138; 95% CI, 1.009–1.284, p = 0.036). Conclusions In near-hanging patients, a high initial serum NSE level is an independent predictor of poor neurological outcome.

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“…Lee et al reported that a combination of NSE level and quantitative parameters in brain CT improved prognostic performance when compared with either component alone in predicting poor neurological outcomes in patients with OHCA 17 . Ryoo et al recently combined the NSE level at 48 h and lactate level measured after ROSC in the prognostic assessment of patients 18 ; the combination yielded no synergic effect. Luescher et al observed that NSE level measured on the third day following cardiac arrest significantly improved the clinical risk scores for outcome predictions 19 .…”

Section: Discussionmentioning

confidence: 99%

Combination of neuron-specific enolase measurement and initial neurological examination for the prediction of neurological outcomes after cardiac arrest

Lee

Kim

Lee

et al. 2021

Sci Rep

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This study aimed to investigate the efficacy of the combination of neuron-specific enolase (NSE) measurement and initial neurological examination in predicting the neurological outcomes of patients with cardiac arrest (CA) by retrospectively analyzing data from the Korean Hypothermia Network prospective registry. NSE levels were recorded at 48 and 72 h after CA. The initial Full Outline of UnResponsiveness (FOUR) and Glasgow Coma Scale (GCS) scores were recorded. These variables were categorized using the scorecard method. The primary endpoint was poor neurological outcomes at 6 months. Of the 475 patients, 171 (36%) had good neurological outcomes at 6 months. The areas under the curve (AUCs) of the categorized NSE levels at 72 h, GCS score, and FOUR score were 0.889, 0.722, and 0.779, respectively. The AUCs of the combinations of categorized NSE levels at 72 h with categorized GCS scores and FOUR score were 0.910 and 0.912, respectively. Each combination was significantly higher than the AUC value of the categorized NSE level at 72 h alone (with GCS: p = 0.015; with FOUR: p = 0.026). Combining NSE measurement and initial neurological examination improved the prediction of neurological outcomes.

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Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management

Cited by 16 publications

References 27 publications

Background Frequency Patterns in Standard Electroencephalography as an Early Prognostic Tool in Out-of-Hospital Cardiac Arrest Survivors Treated with Targeted Temperature Management

Background Frequency Patterns in Standard Electroencephalography as an Early Prognostic Tool in Out-of-Hospital Cardiac Arrest Survivors Treated with Targeted Temperature Management

Neuron-specific enolase level as a predictor of neurological outcome in near-hanging patients: A retrospective multicenter study

Combination of neuron-specific enolase measurement and initial neurological examination for the prediction of neurological outcomes after cardiac arrest

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