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Different neuroprognostication thresholds of neuron-specific enolase in shockable and non-shockable out-of-hospital cardiac arrest: a prospective multicenter observational study in Korea (the KORHN-PRO registry)

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dc.contributor.author박유석-
dc.date.accessioned2023-11-07T07:25:29Z-
dc.date.available2023-11-07T07:25:29Z-
dc.date.issued2023-08-
dc.identifier.issn1364-8535-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/196418-
dc.description.abstractBackground: Serum neuron-specific enolase (NSE) is the only recommended biomarker for multimodal prognostication in postcardiac arrest patients, but low sensitivity of absolute NSE threshold limits its utility. This study aimed to evaluate the prognostic performance of serum NSE for poor neurologic outcome in out-of-hospital cardiac arrest (OHCA) survivors based on their initial rhythm and to determine the NSE cutoff values with false positive rate (FPR) < 1% for each group. Methods: This study included OHCA survivors who received targeted temperature management (TTM) and had serum NSE levels measured at 48 h after return of spontaneous circulation in the Korean Hypothermia Network, a prospective multicenter registry from 22 university-affiliated teaching hospitals in South Korea between October 2015 and December 2018. The primary outcome was poor outcome at 6 month, defined as a cerebral performance category of 3-5. Results: Of 623 patients who underwent TTM with NSE measured 48 h after the return of spontaneous circulation, 245 had an initial shockable rhythm. Median NSE level was significantly higher in the non-shockable group than in the shockable group (104.6 [40.6-228.4] vs. 25.9 [16.7-53.4] ng/mL, P < 0.001). Prognostic performance of NSE assessed by area under the receiver operating characteristic curve to predict poor outcome was significantly higher in the non-shockable group than in the shockable group (0.92 vs 0.86). NSE cutoff values with an FPR < 1% in the non-shockable and shockable groups were 69.3 (sensitivity of 42.1%) and 102.7 ng/mL (sensitivity of 76%), respectively. Conclusion: NSE prognostic performance and its cutoff values with FPR < 1% for predicting poor outcome in OHCA survivors who underwent TTM differed between shockable and non-shockable rhythms, suggesting postcardiac arrest survivor heterogeneity. Trial registration KORHN-PRO, NCT02827422. Registered 11 September 2016-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02827422.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherBioMed Central Ltd-
dc.relation.isPartOfCRITICAL CARE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHCardiopulmonary Resuscitation*-
dc.subject.MESHHumans-
dc.subject.MESHHypothermia, Induced*-
dc.subject.MESHOut-of-Hospital Cardiac Arrest* / therapy-
dc.subject.MESHPhosphopyruvate Hydratase-
dc.subject.MESHPrognosis-
dc.subject.MESHProspective Studies-
dc.subject.MESHRegistries-
dc.titleDifferent neuroprognostication thresholds of neuron-specific enolase in shockable and non-shockable out-of-hospital cardiac arrest: a prospective multicenter observational study in Korea (the KORHN-PRO registry)-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Emergency Medicine (응급의학교실)-
dc.contributor.googleauthorYoun-Jung Kim-
dc.contributor.googleauthorYong Hwan Kim-
dc.contributor.googleauthorChun Song Youn-
dc.contributor.googleauthorIn Soo Cho-
dc.contributor.googleauthorSu Jin Kim-
dc.contributor.googleauthorJung Hee Wee-
dc.contributor.googleauthorYoo Seok Park-
dc.contributor.googleauthorJoo Suk Oh-
dc.contributor.googleauthorByung Kook Lee-
dc.contributor.googleauthorWon Young Kim-
dc.identifier.doi10.1186/s13054-023-04603-6-
dc.contributor.localIdA01592-
dc.relation.journalcodeJ00652-
dc.identifier.eissn1466-609X-
dc.identifier.pmid37559163-
dc.subject.keywordNeuron-specific enolase-
dc.subject.keywordNon-shockable rhythm-
dc.subject.keywordOut-of-hospital cardiac arrest-
dc.subject.keywordPrognosis-
dc.subject.keywordShockable rhythm-
dc.contributor.alternativeNamePark, Yoo Seok-
dc.contributor.affiliatedAuthor박유석-
dc.citation.volume27-
dc.citation.number1-
dc.citation.startPage313-
dc.identifier.bibliographicCitationCRITICAL CARE, Vol.27(1) : 313, 2023-08-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers

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