Source
Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Finland. tuomas.oksanen@hus.fi
Abstract
AIM OF THE STUDY:
To determine the predictive power of the out-of-hospital cardiac arrest (OHCA) score and serum neuron-specific enolase (NSE) in patients resuscitated from ventricular fibrillation treated with therapeutic hypothermia (TH) and glucose control.
METHODS:
An analysis of prospectively collected data of 90 TH patients. Serum NSE was measured at 24 and 48 h. Outcome was measured by neurologic exam 6 months after cardiac arrest with good outcome defined as a Cerebral Performance Category (CPC) of 1 or 2.
RESULTS:
In multiple logistic regression analysis, age (odds ratio [OR], 95% confidence interval 1.1 [1.03-1.18]/year), NSE at 48 h (OR 1.1 [1.02-1.26]/microg/l), and increase in NSE levels (OR 7.2 [1.7-31.3]) were predictors of poor outcome, but the OHCA score was not. Cut-off points with 100% specificity in predicting poor outcome were 33microg/l for NSE at 48h (sensitivity 43% [28-60%]) and 6.4microg/l for delta NSE 24-48 h (sensitivity 44% [28-60%]).
CONCLUSION:
Increase in NSE between 24 and 48h and NSE at 48h is specific but only moderately sensitive markers of 6-month outcome. Outcome prediction at ICU admission using the OHCA score was not possible in this selected patient population.