Yeonho You1, Jung Soo Park2, Jinhong Min1, Insool Yoo3, Hong Joon Ahn1, Yongchul Cho1, Seung Ryu1, Jinwoong Lee1, Seungwhan Kim3, Sunguk Cho1, Sekwang Oh1, Wonjoon Jeong1, Changshin Kang1, Eungseok Oh4, In Ho Lee5, Byungkook Lee6, Donghun Lee6, Chun Song Youn7. 1. Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea. 2. Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea; Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea. Electronic address: cpcr@cnu.ac.kr. 3. Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea; Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea. 4. Department of Neurology, Chungnam National University Hospital, Daejeon, Republic of Korea. 5. Department of Radiology, Chungnam National University Hospital, Daejeon, Republic of Korea. 6. Department of Emergency Medicine, Chonnam National University School of Medicine, Gwangju, Republic of Korea. 7. Department of Emergency Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Abstract
AIM: Cerebrospinal fluid (CSF) neuron-specific enolase (NSE) levels increase ahead of serum NSE levels in patients with severe brain injury. We examined the prognostic performance between CSF NSE and serum NSE levels in out-of-cardiac arrest (OHCA) survivors who had undergone target temperature management (TTM). METHODS: This single-centre prospective observational study included OHCA patients who had undergone TTM. NSE levels were assessed in blood and CSF samples obtained immediately (Day 0), and at 24 h (Day 1), 48 h (Day 2), and 72 h (Day 3) after return of spontaneous circulation (ROSC). The primary outcome was the 6-month neurological outcome. RESULTS: We enrolled 34 patients (males, 24; 70.6%), and 16 (47.1%) had a poor neurologic outcome. CSF NSE and serum NSE values were significantly higher in the poor outcome group compared to the good outcome group at each time point, except for serum Day 0. CSF NSE and serum NSE had an area under curve (AUC) of 0.819-0.972 and 0.648-0.920, respectively. CSF NSE prognostic performances were significantly higher than serum NSE levels at Day 1 and showed excellent AUC values (0.969; 95% confidence interval [CI] 0.844-0.999) and high sensitivity (93.8%; 95% CI 69.8-99.8) at 100% specificity. CONCLUSION: We found CSF NSE values were highly predictive and sensitive markers of 6-month poor neurological outcome in OHCA survivors treated with TTM at Day 1 after ROSC. Therefore, CSF NSE levels at day 1 after ROSC can be a useful early prognosticator in OHCA survivors.
AIM: Cerebrospinal fluid (CSF) neuron-specific enolase (NSE) levels increase ahead of serum NSE levels in patients with severe brain injury. We examined the prognostic performance between CSF NSE and serum NSE levels in out-of-cardiac arrest (OHCA) survivors who had undergone target temperature management (TTM). METHODS: This single-centre prospective observational study included OHCA patients who had undergone TTM. NSE levels were assessed in blood and CSF samples obtained immediately (Day 0), and at 24 h (Day 1), 48 h (Day 2), and 72 h (Day 3) after return of spontaneous circulation (ROSC). The primary outcome was the 6-month neurological outcome. RESULTS: We enrolled 34 patients (males, 24; 70.6%), and 16 (47.1%) had a poor neurologic outcome. CSF NSE and serum NSE values were significantly higher in the poor outcome group compared to the good outcome group at each time point, except for serum Day 0. CSF NSE and serum NSE had an area under curve (AUC) of 0.819-0.972 and 0.648-0.920, respectively. CSF NSE prognostic performances were significantly higher than serum NSE levels at Day 1 and showed excellent AUC values (0.969; 95% confidence interval [CI] 0.844-0.999) and high sensitivity (93.8%; 95% CI 69.8-99.8) at 100% specificity. CONCLUSION: We found CSF NSE values were highly predictive and sensitive markers of 6-month poor neurological outcome in OHCA survivors treated with TTM at Day 1 after ROSC. Therefore, CSF NSE levels at day 1 after ROSC can be a useful early prognosticator in OHCA survivors.
Authors: Claudio Sandroni; Sonia D'Arrigo; Sofia Cacciola; Cornelia W E Hoedemaekers; Marlijn J A Kamps; Mauro Oddo; Fabio S Taccone; Arianna Di Rocco; Frederick J A Meijer; Erik Westhall; Massimo Antonelli; Jasmeet Soar; Jerry P Nolan; Tobias Cronberg Journal: Intensive Care Med Date: 2020-09-11 Impact factor: 17.440
Authors: Seung Ha Son; Yong Nam In; Jung Soo Park; Yeonho You; Jin Hong Min; Insool Yoo; Yong Chul Cho; Wonjoon Jeong; Hong Joon Ahn; Changshin Kang; Byung Kook Lee Journal: Neurocrit Care Date: 2021-01-11 Impact factor: 3.210
Authors: Seung Ha Son; In Ho Lee; Jung Soo Park; In Sool Yoo; Seung Whan Kim; Jin Woong Lee; Seung Ryu; Yeonho You; Jin Hong Min; Yong Chul Cho; Won Joon Jeong; Se Kwang Oh; Sung Uk Cho; Hong Joon Ahn; Changshin Kang; Dong Hun Lee; Byung Kook Lee; Chun Song Youn Journal: J Clin Med Date: 2020-03-10 Impact factor: 4.241