Dongwook Lee1, Yongil Cho2, Yujin Ko3, Nam Hun Heo4, Hyung Goo Kang2, Sangsoo Han5. 1. Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea. 2. Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea. 3. Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea. 4. Department of Biostatistics, Clinical Trial Center, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea. 5. Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
Abstract
OBJECTIVES: Neuron-specific enolase (NSE) is frequently used to predict neurological outcomes in patients with hypoxic brain injury. Hanging can cause hypoxic brain damage, and survivors can suffer from neurological deficits that may impair daily activities. Here, we investigated the utility of the initial serum NSE level as a predictor of neurological outcomes in near-hanging patients with decreased consciousness. METHODS: This retrospective multicenter study was conducted in patients who visited the emergency department due to near-hanging injury from October 2013 to February 2019 at three university hospitals in Korea. They were divided into two groups according to the presence of out-of-hospital cardiac arrest. The neurological outcome was determined using the Cerebral Performance Category (CPC) measured at the time of discharge. Multivariate analysis was performed to determine whether initial serum NSE is an independent predictor of neurological outcome. RESULTS: Of the 70 patients included in the study, 44 showed a poor neurological outcome (CPC score = 3-5). Among the 52 patients with cardiac arrest, only 10 (19.2%) were discharged with good neurological outcome (CPC score = 1-2). In the whole cohort, a high serum NSE level was a significant predictor of poor neurological outcome (odds ratio [OR], 1.343; 95% confidence interval [CI], 1.003-1.800, p = 0.048). Among the patients with cardiac arrest, a high serum NSE level was a significant predictor of poor neurological outcome (OR, 1.138; 95% CI, 1.009-1.284, p = 0.036). CONCLUSIONS: In near-hanging patients, a high initial serum NSE level is an independent predictor of poor neurological outcome.
OBJECTIVES:Neuron-specific enolase (NSE) is frequently used to predict neurological outcomes in patients with hypoxic brain injury. Hanging can cause hypoxic brain damage, and survivors can suffer from neurological deficits that may impair daily activities. Here, we investigated the utility of the initial serum NSE level as a predictor of neurological outcomes in near-hanging patients with decreased consciousness. METHODS: This retrospective multicenter study was conducted in patients who visited the emergency department due to near-hanging injury from October 2013 to February 2019 at three university hospitals in Korea. They were divided into two groups according to the presence of out-of-hospital cardiac arrest. The neurological outcome was determined using the Cerebral Performance Category (CPC) measured at the time of discharge. Multivariate analysis was performed to determine whether initial serum NSE is an independent predictor of neurological outcome. RESULTS: Of the 70 patients included in the study, 44 showed a poor neurological outcome (CPC score = 3-5). Among the 52 patients with cardiac arrest, only 10 (19.2%) were discharged with good neurological outcome (CPC score = 1-2). In the whole cohort, a high serum NSE level was a significant predictor of poor neurological outcome (odds ratio [OR], 1.343; 95% confidence interval [CI], 1.003-1.800, p = 0.048). Among the patients with cardiac arrest, a high serum NSE level was a significant predictor of poor neurological outcome (OR, 1.138; 95% CI, 1.009-1.284, p = 0.036). CONCLUSIONS: In near-hanging patients, a high initial serum NSE level is an independent predictor of poor neurological outcome.
Authors: Charles D Kato; Dorothy Twesigye; Vincent P Alibu; Ann Nanteza; Julius Nsubuga; Claire M Mugasa; Enock Matovu Journal: BMC Res Notes Date: 2022-03-07
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