Lauri Wihersaari1, Marjaana Tiainen2, Markus B Skrifvars3, Stepani Bendel4, Kirsi-Maija Kaukonen5, Jukka Vaahersalo6, Jarkko Romppanen7, Ville Pettilä6, Matti Reinikainen8. 1. Department of Anaesthesiology and Intensive Care, North Karelia Central Hospital, Joensuu, Finland; Department of Anaesthesiology, Kuopio University Hospital, Kuopio, Finland. Electronic address: lauri.wihersaari@kuh.fi. 2. Department of Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 3. Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 4. Department of Intensive Care, Kuopio University Hospital, Kuopio, Finland. 5. Finnish Medicines Agency, Helsinki, Finland. 6. Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 7. Eastern Finland Laboratory Centre, Kuopio, Finland. 8. Department of Anaesthesiology and Intensive Care, North Karelia Central Hospital, Joensuu, Finland; Department of Anaesthesiology, Kuopio University Hospital, Kuopio, Finland; University of Eastern Finland, Kuopio, Finland.
Abstract
AIM OF THE STUDY: We evaluated the impact of patient age and time from collapse to return of spontaneous circulation (ROSC) on the prognostic accuracy of neuron specific enolase (NSE) after out-of-hospital cardiac arrest (OHCA). METHODS: Using electrochemiluminescence immunoassay, we measured serum concentrations of NSE in 249 patients who were admitted to intensive care units after resuscitation from OHCA. In each quartile according to age and time to ROSC, we evaluated the ability of NSE at 48 h after OHCA to predict poor outcome (Cerebral Performance Category 3-5) at 12 months. RESULTS: The outcome at 12 months was poor in 121 (49%) patients. The prognostic performance of NSE was excellent (area under the receiver operating characteristic curve, AUROC, 0.91 [95% confidence interval, 0.81-1.00]) in the youngest quartile (18-56 years), but worsened with increasing age, and was poor (AUROC 0.53 [0.37-0.70]) in the oldest quartile (72 years or more). The prognostic performance of NSE was worthless (AUROC 0.45 [0.30-0.61]) in the quartile with the shortest time to ROSC (1-13 min), but improved with increasing time to ROSC, and was good (AUROC 0.84 [0.74-0.95]) in the quartile with the longest time to ROSC (29 min or over). CONCLUSION: NSE at 48 h after OHCA is a useful predictor of 12-month-prognosis in young patients and in patients with a long time from collapse to ROSC, but not in old patients or patients with a short time to ROSC.
AIM OF THE STUDY: We evaluated the impact of patient age and time from collapse to return of spontaneous circulation (ROSC) on the prognostic accuracy of neuron specific enolase (NSE) after out-of-hospital cardiac arrest (OHCA). METHODS: Using electrochemiluminescence immunoassay, we measured serum concentrations of NSE in 249 patients who were admitted to intensive care units after resuscitation from OHCA. In each quartile according to age and time to ROSC, we evaluated the ability of NSE at 48 h after OHCA to predict poor outcome (Cerebral Performance Category 3-5) at 12 months. RESULTS: The outcome at 12 months was poor in 121 (49%) patients. The prognostic performance of NSE was excellent (area under the receiver operating characteristic curve, AUROC, 0.91 [95% confidence interval, 0.81-1.00]) in the youngest quartile (18-56 years), but worsened with increasing age, and was poor (AUROC 0.53 [0.37-0.70]) in the oldest quartile (72 years or more). The prognostic performance of NSE was worthless (AUROC 0.45 [0.30-0.61]) in the quartile with the shortest time to ROSC (1-13 min), but improved with increasing time to ROSC, and was good (AUROC 0.84 [0.74-0.95]) in the quartile with the longest time to ROSC (29 min or over). CONCLUSION:NSE at 48 h after OHCA is a useful predictor of 12-month-prognosis in young patients and in patients with a long time from collapse to ROSC, but not in old patients or patients with a short time to ROSC.
Authors: Jerry P Nolan; Claudio Sandroni; Bernd W Böttiger; Alain Cariou; Tobias Cronberg; Hans Friberg; Cornelia Genbrugge; Kirstie Haywood; Gisela Lilja; Véronique R M Moulaert; Nikolaos Nikolaou; Theresa Mariero Olasveengen; Markus B Skrifvars; Fabio Taccone; Jasmeet Soar Journal: Intensive Care Med Date: 2021-03-25 Impact factor: 17.440
Authors: Adrian Quinto; Maja Ramin-Wright; Sabina Hunziker; Christoph Becker; Katharina Beck; Alessia Vincent; Kai Tisljar; Giulio Disanto; Pascal Benkert; David Leppert; Hans Pargger; Stephan Marsch; Nils Peters; Jens Kuhle Journal: Crit Care Date: 2021-01-20 Impact factor: 9.097
Authors: Lauri Wihersaari; Nicholas J Ashton; Matti Reinikainen; Pekka Jakkula; Ville Pettilä; Johanna Hästbacka; Marjaana Tiainen; Pekka Loisa; Hans Friberg; Tobias Cronberg; Kaj Blennow; Henrik Zetterberg; Markus B Skrifvars Journal: Intensive Care Med Date: 2020-08-27 Impact factor: 17.440