Predicting Outcomes in Comatose Cardiac Arrest Survivors Using Serum Neuron-Specific Enolase
Author Information
Author(s): Daubin Cédric, Quentin Charlotte, Allouche Stéphane, Etard Olivier, Gaillard Cathy, Seguin Amélie, Valette Xavier, Parienti Jean-Jacques, Prevost Fabrice, Ramakers Michel, Terzi Nicolas, Charbonneau Pierre, du Cheyron Damien
Primary Institution: CHU de Caen
Hypothesis
Can serum neuron-specific enolase (NSE) predict death or vegetative state in comatose cardiac-arrest survivors?
Conclusion
Higher levels of serum NSE in comatose patients after cardiac arrest are associated with poor outcomes, and a cut-off value of 97 ng/mL can predict such outcomes with high accuracy.
Supporting Evidence
- 74% of patients had a poor outcome (CPC 4-5) at 3 months.
- NSE levels at 24 h and 72 h were significantly higher in patients with poor outcomes.
- A cut-off value of 97 ng/mL for NSE predicted poor outcomes with 100% specificity.
- An approach combining NSE, SSEPs, and clinical-EEG tests identified 88% of patients with poor outcomes.
Takeaway
Doctors can check a blood test for a substance called NSE to see if someone who is unconscious after a heart problem might not get better. If the NSE level is really high, it means they might not wake up.
Methodology
A prospective observational cohort study was conducted in two hospitals, measuring serum NSE levels at 24 and 72 hours after cardiac arrest and assessing outcomes at 3 months.
Potential Biases
The study's design may introduce bias as clinicians were blinded to NSE results, but the lack of informed consent could affect the generalizability of the findings.
Limitations
The study had a relatively small sample size and potential biases due to the observational nature and the lack of informed consent.
Participant Demographics
The study included 97 patients, predominantly male (77%), with an average age of 57 years.
Statistical Information
P-Value
p<0.0001
Confidence Interval
[95% CI = 87-100]
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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