Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial.
cardiac arrest
cardiopulmonary resuscitation
long-term mortality
neurological outcome
neuron-specific enolase
prognostication
Journal
Medicines (Basel, Switzerland)
ISSN: 2305-6320
Titre abrégé: Medicines (Basel)
Pays: Switzerland
ID NLM: 101671069
Informations de publication
Date de publication:
17 Nov 2021
17 Nov 2021
Historique:
received:
16
08
2021
revised:
09
11
2021
accepted:
12
11
2021
entrez:
25
11
2021
pubmed:
26
11
2021
medline:
26
11
2021
Statut:
epublish
Résumé
We investigated whether Neuron-specific enolase (NSE) serum concentration predicts long-term mortality and poor neurological outcome in adult cardiac arrest patients. Within this prospective observational study, we included consecutive adult patients admitted to the intensive care unit (ICU) after cardiac arrest. NSE was measured upon ICU admission and on days 1, 2, 3, 5 and 7. Of 403 patients, 176 (43.7%) survived. Median follow-up duration was 43.7 months (IQR 14.3 to 63.0 months). NSE levels on day 3 were increased more than threefold in non-survivors compared to survivors (median NSE (ng/mL) 19.8 (IQR 15.7 to 27.8) vs. 72.6 (IQR 26 to 194)) and showed the highest prognostic performance for mortality compared to other days of measurement, with an AUC of 0.81 and an adjusted hazard ratio of 1.55 (95% CI 1.41 to 1.71, NSE measured three days after cardiac arrest is associated with long-term mortality and neurological outcome and may provide prognostic information that improves clinical decision making. Particularly in the subgroup of younger patients (<54 years), NSE showed excellent negative predictive value.
Sections du résumé
BACKGROUND
BACKGROUND
We investigated whether Neuron-specific enolase (NSE) serum concentration predicts long-term mortality and poor neurological outcome in adult cardiac arrest patients.
METHODS
METHODS
Within this prospective observational study, we included consecutive adult patients admitted to the intensive care unit (ICU) after cardiac arrest. NSE was measured upon ICU admission and on days 1, 2, 3, 5 and 7.
RESULTS
RESULTS
Of 403 patients, 176 (43.7%) survived. Median follow-up duration was 43.7 months (IQR 14.3 to 63.0 months). NSE levels on day 3 were increased more than threefold in non-survivors compared to survivors (median NSE (ng/mL) 19.8 (IQR 15.7 to 27.8) vs. 72.6 (IQR 26 to 194)) and showed the highest prognostic performance for mortality compared to other days of measurement, with an AUC of 0.81 and an adjusted hazard ratio of 1.55 (95% CI 1.41 to 1.71,
CONCLUSION
CONCLUSIONS
NSE measured three days after cardiac arrest is associated with long-term mortality and neurological outcome and may provide prognostic information that improves clinical decision making. Particularly in the subgroup of younger patients (<54 years), NSE showed excellent negative predictive value.
Identifiants
pubmed: 34822369
pii: medicines8110072
doi: 10.3390/medicines8110072
pmc: PMC8624292
pii:
doi:
Types de publication
Journal Article
Langues
eng
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