The neuron specific enolase (NSE) ratio offers benefits over absolute value thresholds in post-cardiac arrest coma prognosis.
J Clin Neurosci
; 57: 99-104, 2018 Nov.
Article
em En
| MEDLINE
| ID: mdl-30145080
ABSTRACT
INTRODUCTION:
Serum neuron-specific enolase (NSE) levels have been shown to correlate with neurologic outcome in comatose survivors of cardiac arrest but use of absolute NSE thresholds is limited. This study describes and evaluates a novel approach to analyzing NSE, the NSE ratio, and evaluates the prognostic utility of NSE absolute value thresholds and trends over time.METHODS:
100 consecutive adult comatose cardiac arrest survivors were prospectively enrolled. NSE levels were assessed at 24, 48, and 72â¯h post-arrest. Primary outcome was the Glasgow Outcome Score (GOS) at 6â¯months post-arrest; good outcome was defined as GOS 3-5. Absolute and relative NSE values (i.e. the NSE ratio), peak values, and the trend in NSE over 72â¯h were analyzed.RESULTS:
98 patients were included. 42 (43%) had a good outcome. Five good outcome patients had peak NSE >33⯵g/L (34.9-46.4⯵g/L). NSE trends between 24 and 48â¯h differed between outcome groups (decrease by 3.0⯵g/L (0.9-7.0⯵g/L) vs. increase by 13.4⯵g/L (-3.7 to 69.4⯵g/L), good vs. poor, pâ¯=â¯0.004). The 4824â¯h NSE ratio differed between the good and poor outcome groups (0.8 (0.6-0.9) vs. 1.4 (0.8-2.5), pâ¯=â¯0.001), and a 4824â¯h ratio of ≥1.7 was 100% specific for poor outcome.CONCLUSIONS:
The NSE ratio is a unique method to quantify NSE changes over time. Values greater than 1.0 indicate increasing NSE and may be reflective of ongoing neuronal injury. The NSE ratio obviates the need for an absolute value cut-off.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Fosfopiruvato Hidratase
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Coma
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Parada Cardíaca
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Neurosci
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos