Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial

Background: We investigated whether Neuron-specific enolase (NSE) serum concentration predicts long-term mortality and poor neurological outcome in adult cardiac arrest patients. Methods: Within this prospective observational study, we included consecutive adult patients admitted to the intensive ca...

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Autores principales:	Jonas Müller, Benjamin Bissmann, Christoph Becker, Katharina Beck, Nina Loretz, Sebastian Gross, Simon A. Amacher, Chantal Bohren, Hans Pargger, Kai Tisljar, Raoul Sutter, Stephan Marsch, Sabina Hunziker
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	cardiac arrest cardiopulmonary resuscitation neuron-specific enolase prognostication long-term mortality neurological outcome Medicine R
Acceso en línea:	https://doaj.org/article/1bdad4b61e214ffea54ea06369b610db
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spelling	oai:doaj.org-article:1bdad4b61e214ffea54ea06369b610db2021-11-25T18:19:22ZNeuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial10.3390/medicines81100722305-6320https://doaj.org/article/1bdad4b61e214ffea54ea06369b610db2021-11-01T00:00:00Zhttps://www.mdpi.com/2305-6320/8/11/72https://doaj.org/toc/2305-6320Background: We investigated whether Neuron-specific enolase (NSE) serum concentration predicts long-term mortality and poor neurological outcome in adult cardiac arrest patients. Methods: Within this prospective observational study, we included consecutive adult patients admitted to the intensive care unit (ICU) after cardiac arrest. NSE was measured upon ICU admission and on days 1, 2, 3, 5 and 7. Results: Of 403 patients, 176 (43.7%) survived. Median follow-up duration was 43.7 months (IQR 14.3 to 63.0 months). NSE levels on day 3 were increased more than threefold in non-survivors compared to survivors (median NSE (ng/mL) 19.8 (IQR 15.7 to 27.8) vs. 72.6 (IQR 26 to 194)) and showed the highest prognostic performance for mortality compared to other days of measurement, with an AUC of 0.81 and an adjusted hazard ratio of 1.55 (95% CI 1.41 to 1.71, <i>p</i> < 0.001). Subgroup analysis showed an excellent sensitivity and negative predictive value of 100% of NSE in patients <54 years of age. Conclusion: NSE measured three days after cardiac arrest is associated with long-term mortality and neurological outcome and may provide prognostic information that improves clinical decision making. Particularly in the subgroup of younger patients (<54 years), NSE showed excellent negative predictive value.Jonas MüllerBenjamin BissmannChristoph BeckerKatharina BeckNina LoretzSebastian GrossSimon A. AmacherChantal BohrenHans ParggerKai TisljarRaoul SutterStephan MarschSabina HunzikerMDPI AGarticlecardiac arrestcardiopulmonary resuscitationneuron-specific enolaseprognosticationlong-term mortalityneurological outcomeMedicineRENMedicines, Vol 8, Iss 72, p 72 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiac arrest cardiopulmonary resuscitation neuron-specific enolase prognostication long-term mortality neurological outcome Medicine R
spellingShingle	cardiac arrest cardiopulmonary resuscitation neuron-specific enolase prognostication long-term mortality neurological outcome Medicine R Jonas Müller Benjamin Bissmann Christoph Becker Katharina Beck Nina Loretz Sebastian Gross Simon A. Amacher Chantal Bohren Hans Pargger Kai Tisljar Raoul Sutter Stephan Marsch Sabina Hunziker Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial
description	Background: We investigated whether Neuron-specific enolase (NSE) serum concentration predicts long-term mortality and poor neurological outcome in adult cardiac arrest patients. Methods: Within this prospective observational study, we included consecutive adult patients admitted to the intensive care unit (ICU) after cardiac arrest. NSE was measured upon ICU admission and on days 1, 2, 3, 5 and 7. Results: Of 403 patients, 176 (43.7%) survived. Median follow-up duration was 43.7 months (IQR 14.3 to 63.0 months). NSE levels on day 3 were increased more than threefold in non-survivors compared to survivors (median NSE (ng/mL) 19.8 (IQR 15.7 to 27.8) vs. 72.6 (IQR 26 to 194)) and showed the highest prognostic performance for mortality compared to other days of measurement, with an AUC of 0.81 and an adjusted hazard ratio of 1.55 (95% CI 1.41 to 1.71, <i>p</i> < 0.001). Subgroup analysis showed an excellent sensitivity and negative predictive value of 100% of NSE in patients <54 years of age. Conclusion: NSE measured three days after cardiac arrest is associated with long-term mortality and neurological outcome and may provide prognostic information that improves clinical decision making. Particularly in the subgroup of younger patients (<54 years), NSE showed excellent negative predictive value.
format	article
author	Jonas Müller Benjamin Bissmann Christoph Becker Katharina Beck Nina Loretz Sebastian Gross Simon A. Amacher Chantal Bohren Hans Pargger Kai Tisljar Raoul Sutter Stephan Marsch Sabina Hunziker
author_facet	Jonas Müller Benjamin Bissmann Christoph Becker Katharina Beck Nina Loretz Sebastian Gross Simon A. Amacher Chantal Bohren Hans Pargger Kai Tisljar Raoul Sutter Stephan Marsch Sabina Hunziker
author_sort	Jonas Müller
title	Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial
title_short	Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial
title_full	Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial
title_fullStr	Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial
title_full_unstemmed	Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial
title_sort	neuron-specific enolase (nse) predicts long-term mortality in adult patients after cardiac arrest: results from a prospective trial
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/1bdad4b61e214ffea54ea06369b610db
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Neuron-Specific Enolase (NSE) Predicts Long-Term Mortality in Adult Patients after Cardiac Arrest: Results from a Prospective Trial

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