Neuron-specific enolase concentrations for the prediction of poor prognosis of comatose patients after out-of-hospital cardiac arrest: an observational cohort study

Ryczek, Robert; Kwasiborski, Przemysław; Dymus, Jolanta; Galas, Agata; Kaźmierczak‐Dziuk, Anna; Karasek, Anna M; Mielniczuk, Marta; Buksińska−Lisik, Małgorzata; Krzesiński, Paweł

doi:10.33963/kp.15917

Cited by 3 publications

(4 citation statements)

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“…Subsequently, 62 papers were removed from the analysis since they lacked a contro group or did not provide any relevant data. A thorough investigation was undertaken, encompassing a total of 86 studies tha met all the stated criteria for inclusion [12,15,. The aforementioned papers wer then incorporated into the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Importantly, these factors elevated the risk of hemolysis, interfering with accurate NSE determination [14]. Nevertheless, repeated measurements indicating an increase in NSE concentration values between 48 and 72 h after cardiac arrest may have been an element of an algorithm predicting poor neurological outcomes [15]. The proposed other prognostic algorithm could also include a combination of neurofilament light (NfL) and NSE by measuring NfL at 24, 48, and 72 h after cardiac arrest, and NSE at 72 h [16].…”

Section: Introductionmentioning

confidence: 99%

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Predictive Performance of Neuron-Specific Enolase (NSE) for Survival after Resuscitation from Cardiac Arrest: A Systematic Review and Meta-Analysis

Kurek,

Swieczkowski,

Pruc

et al. 2023

JCM

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The prediction of outcomes following cardiac arrest continues to provide significant difficulties. A preferred strategy involves adopting a multimodal approach, which encompasses the careful evaluation of the biomarker neuron-specific enolase (NSE). This systematic review and meta-analysis aimed to gather and summarize new and existing evidence on the prediction effect of neuron-specific enolase for survival to hospital discharge among adult patients with cardiac arrest. We searched PubMed Central, Scopus, EMBASE databases, and the Cochrane Library without language restrictions from their inceptions until 30 October 2023 and checked the reference lists of the included studies. Pooled results were reported as standardized mean differences (SMDs) and were presented with corresponding 95% confidence intervals (CIs). The primary outcome was survival to hospital discharge (SHD). Eighty-six articles with 10,845 participants were included. NSE showed a notable degree of specificity in its ability to predict mortality as well as neurological status among individuals who experienced cardiac arrest (p < 0.05). This study demonstrates the ability to predict fatality rates and neurological outcomes, both during the time of admission and at various time intervals after cardiac arrest. The use of NSE in a multimodal neuroprognostication algorithm has promise in improving the accuracy of prognoses for persons who have undergone cardiac arrest.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictive Performance of Neuron-Specific Enolase (NSE) for Survival after Resuscitation from Cardiac Arrest: A Systematic Review and Meta-Analysis

Kurek,

Swieczkowski,

Pruc

et al. 2023

JCM

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show abstract

“…Although earlier studies have suggested to combine neuromarkers with other modalities trying to predict neurological prognosis, a NSE cut-off above 97 ng/ml had been suggested ( 34 ). Others have calculated different sometimes lower cut-offs, in particular when assessing the 72 h time-point ( 35 ). Depending on local protocols, cut-offs for one specific neuromarker might differ between populations.…”

Section: Discussionmentioning

confidence: 99%

Additive Impact of Interleukin 6 and Neuron Specific Enolase for Prognosis in Patients With Out-of-Hospital Cardiac Arrest – Experience From the HAnnover COoling REgistry

Akin

Sieweke

Garcheva

et al. 2022

Front. Cardiovasc. Med.

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BackgroundPatients after out-of-hospital cardiac arrest (OHCA) are at increased risk for mortality and poor neurological outcome. We assessed the additive impact of interleukin 6 (IL-6) at admission to neuron-specific enolase (NSE) at day 3 for prognosis of 30-day mortality and long-term neurological outcome in OHCA patients.MethodsA total of 217 patients from the HAnnover COoling REgistry with return of spontaneous circulation (ROSC) after OHCA and IL-6 measurement immediately after admission during 2017–2020 were included to investigate the prognostic value and importance of IL-6 in addition to NSE obtained on day 3. Poor neurological outcome was defined by cerebral performance category (CPC) ≥ 3 after 6 months.ResultsPatients with poor outcome showed higher IL-6 values (30-day mortality: 2,224 ± 524 ng/l vs 186 ± 15 ng/l, p < 0.001; CPC ≥ 3 at 6 months: 1,440 ± 331 ng/l vs 180 ± 24 ng/l, p < 0.001). IL-6 was an independent predictor of mortality (HR = 1.013/ng/l; 95% CI 1.007–1.019; p < 0.001) and poor neurological outcome (HR = 1.004/ng/l; 95% CI 1.001–1.007; p = 0.036). In ROC-analysis, AUC for IL-6 was 0.98 (95% CI 0.96–0.99) for mortality, but only 0.76 (95% CI 0.68–0.84) for poor neurological outcome. The determined cut-off value for IL-6 was 431 ng/l for mortality (NPV 89.2%). In patients with IL-6 > 431 ng/l, the combination with NSE < 46 μg/l optimally identified those individuals with potential for good neurological outcome (CPC ≤ 2).ConclusionElevated IL-6 levels at admission after ROSC were closely associated with 30-day mortality. The combination of IL-6 and NSE provided clinically important additive information for predict poor neurological outcome at 6 months.

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“…In recent years, plasma measurements of neuron-specific enolase (NSE) have been used in neurological diagnostics of nervous system damage. Neuronal damage leads to an increase in the concentration of this enzyme in blood plasma and is used as an indicator of brain damage in conditions where neurons are destroyed relatively rapidly [1,2].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of microdamage to the central nervous system expressed by an increase in plasma concentration of specific neuronal enolase in the course of vasovagal syncope

et al. 2023

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Neuron-specific enolase concentrations for the prediction of poor prognosis of comatose patients after out-of-hospital cardiac arrest: an observational cohort study

Cited by 3 publications

References 0 publications

Predictive Performance of Neuron-Specific Enolase (NSE) for Survival after Resuscitation from Cardiac Arrest: A Systematic Review and Meta-Analysis

Predictive Performance of Neuron-Specific Enolase (NSE) for Survival after Resuscitation from Cardiac Arrest: A Systematic Review and Meta-Analysis

Additive Impact of Interleukin 6 and Neuron Specific Enolase for Prognosis in Patients With Out-of-Hospital Cardiac Arrest – Experience From the HAnnover COoling REgistry

Evaluation of microdamage to the central nervous system expressed by an increase in plasma concentration of specific neuronal enolase in the course of vasovagal syncope

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