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Neuron-specific enolase and long-term neurological outcome after OHCA – A validation study

Lissner Östlund, Emilie ; Levin, Helena LU ; Nielsen, Niklas LU ; Frigyesi, Attila LU and Lybeck, Anna LU orcid (2021) In Resuscitation 168. p.206-213
Abstract

Aims: To investigate what NSE levels predict long-term neurological prognosis at 24, 48 and 72 hours after ROSC in a cohort of out-of-hospital cardiac arrest and to validate previously suggested NSE cut-offs, including the latest ERC guidelines (2021). Methods: Patients admitted to intensive care units in four hospitals in Southern Sweden between 2014–2018 were included. Blood samples were handled by a single local laboratory. The primary outcome was neurological outcome according to the Cerebral Performance Category (CPC) scale at 2–6 months after cardiac arrest. Results: 368 patients were included for analysis. A ≤2% false positive rate for the prediction of poor neurological outcome was achieved with an NSE cut-off value of >101... (More)

Aims: To investigate what NSE levels predict long-term neurological prognosis at 24, 48 and 72 hours after ROSC in a cohort of out-of-hospital cardiac arrest and to validate previously suggested NSE cut-offs, including the latest ERC guidelines (2021). Methods: Patients admitted to intensive care units in four hospitals in Southern Sweden between 2014–2018 were included. Blood samples were handled by a single local laboratory. The primary outcome was neurological outcome according to the Cerebral Performance Category (CPC) scale at 2–6 months after cardiac arrest. Results: 368 patients were included for analysis. A ≤2% false positive rate for the prediction of poor neurological outcome was achieved with an NSE cut-off value of >101 μg/L at 48 hours and >80 μg/L at 72 hours. The cut-off suggested by the recent ERC guidelines of >60 μg/L at 48 and/or 72 hours generated a false positive rate of 4.3% (95 %CI 0.9–7.4%). Conclusion: A local validation study of the ability of serum levels of neuron-specific enolase to predict long-term poor neurological outcome after out-of-hospital cardiac arrest generated higher cut-offs than suggested by previous publications.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Biomarker, Cardiac arrest, Neuro prognostication, Neuron-specific enolase, Outcome
in
Resuscitation
volume
168
pages
206 - 213
publisher
Elsevier
external identifiers
  • pmid:34508799
  • scopus:85115933013
ISSN
0300-9572
DOI
10.1016/j.resuscitation.2021.09.001
project
SweCrit, a critical care biobank
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 Elsevier B.V.
id
5334cdc1-4331-47bb-a1dc-ed6b2dfe43ba
date added to LUP
2021-10-25 13:40:59
date last changed
2024-06-15 18:56:01
@article{5334cdc1-4331-47bb-a1dc-ed6b2dfe43ba,
  abstract     = {{<p>Aims: To investigate what NSE levels predict long-term neurological prognosis at 24, 48 and 72 hours after ROSC in a cohort of out-of-hospital cardiac arrest and to validate previously suggested NSE cut-offs, including the latest ERC guidelines (2021). Methods: Patients admitted to intensive care units in four hospitals in Southern Sweden between 2014–2018 were included. Blood samples were handled by a single local laboratory. The primary outcome was neurological outcome according to the Cerebral Performance Category (CPC) scale at 2–6 months after cardiac arrest. Results: 368 patients were included for analysis. A ≤2% false positive rate for the prediction of poor neurological outcome was achieved with an NSE cut-off value of &gt;101 μg/L at 48 hours and &gt;80 μg/L at 72 hours. The cut-off suggested by the recent ERC guidelines of &gt;60 μg/L at 48 and/or 72 hours generated a false positive rate of 4.3% (95 %CI 0.9–7.4%). Conclusion: A local validation study of the ability of serum levels of neuron-specific enolase to predict long-term poor neurological outcome after out-of-hospital cardiac arrest generated higher cut-offs than suggested by previous publications.</p>}},
  author       = {{Lissner Östlund, Emilie and Levin, Helena and Nielsen, Niklas and Frigyesi, Attila and Lybeck, Anna}},
  issn         = {{0300-9572}},
  keywords     = {{Biomarker; Cardiac arrest; Neuro prognostication; Neuron-specific enolase; Outcome}},
  language     = {{eng}},
  pages        = {{206--213}},
  publisher    = {{Elsevier}},
  series       = {{Resuscitation}},
  title        = {{Neuron-specific enolase and long-term neurological outcome after OHCA – A validation study}},
  url          = {{http://dx.doi.org/10.1016/j.resuscitation.2021.09.001}},
  doi          = {{10.1016/j.resuscitation.2021.09.001}},
  volume       = {{168}},
  year         = {{2021}},
}