Are serial neuron-specific enolase levels associated with neurologic outcome of ECPR patients: A retrospective multicenter observational study
- Authors
- Kim, H.B.[Kim, H.B.]; Yang, J.H.[Yang, J.H.]; Lee, Y.H.[Lee, Y.H.]
- Issue Date
- 1-Jul-2023
- Publisher
- W.B. Saunders
- Keywords
- Cardiopulmonary resuscitation; Extracorporeal cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Neurologic outcome; Neuron-specific enolase
- Citation
- American Journal of Emergency Medicine, v.69, pp.58 - 64
- Indexed
- SCIE
SCOPUS
- Journal Title
- American Journal of Emergency Medicine
- Volume
- 69
- Start Page
- 58
- End Page
- 64
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/104193
- DOI
- 10.1016/j.ajem.2023.03.047
- ISSN
- 0735-6757
- Abstract
- Aim of the study: This study aims to evaluate whether neuron-specific enolase (NSE) level at 48 h after extracorporeal cardiopulmonary resuscitation (ECPR) is associated with neurologic outcomes at 6 months after hospital discharge. Methods: This was a retrospective, multicenter, observational study of adult patients who received ECPR between May 2010 and December 2016. In the two hospitals involved in this study, NSE measurements were a routine part of the protocol for patients who received ECPR. Serial NSE levels were measured in all patients with ECPR. NSE levels were measured 24, 48, and 72 h after ECPR. The primary outcome was Cerebral Performance Categories (CPC) scale at 6 months after hospital discharge according to NSE levels at 48 h after ECPR. Results: At follow-up 6 months after hospital discharge, favorable neurologic outcomes of CPC 1 or 2 were observed in 9 (36.0%) of the 25 patients, and poor neurologic outcomes of CPC 3, 4, or 5 were observed in 16 (64%) patients. NSE levels at 24 h in the favorable and poor neurologic outcome groups were 58.3 (52.5–73.2) μg/L and 64.2 (37.9–89.8) μg/L, respectively (p = 0.95). NSE levels at 48 h in the favorable and poor neurologic outcome groups were 52.1 (22.3–64.9) μg/L and 302.0 (62.8–360.2) μg/L, respectively (p = 0.01). NSE levels at 72 h were 37.2 (12.5–53.2) μg/L and 240.9 (75.3–370.0) μg/L, respectively (p < 0.01). In receiver operating characteristic (ROC) curve analysis, as the predictor of poor outcome, the optimal cut-off value for NSE level at 48 h was 140.5 μg/L, and the area under the curve (AUC) was 0.844 (p < 0.01). The optimal cut-off NSE level at 72 h was 53.2 μg/L, and the AUC was 0.897 (p < 0.01). Conclusions: NSE level at 72 h displayed the highest association with neurologic outcome after ECPR, and NSE level at 48 h was also associated with neurologic outcome after ECPR. © 2023
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