Predictive power of serum NSE and OHCA score regarding 6-month neurologic outcome after out-of-hospital ventricular fibrillation and therapeutic hypothermia

Autor: Maaret Castrén, Tero Varpula, Marjaana Tiainen, Tuomas Oksanen, Anne Kuitunen, Ville Pettilä, Markus B. Skrifvars
Rok vydání: 2009
Předmět:
Blood Glucose
Male
endocrine system
medicine.medical_specialty
Time Factors
medicine.medical_treatment
030204 cardiovascular system & hematology
Emergency Nursing
Sensitivity and Specificity
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Hypothermia
Induced
Predictive Value of Tests
Internal medicine
Intensive care
Outcome Assessment
Health Care
Severity of illness
medicine
Humans
Prospective Studies
Cardiopulmonary resuscitation
Prospective cohort study
Aged
Neurologic Examination
business.industry
Age Factors
030208 emergency & critical care medicine
Odds ratio
Middle Aged
medicine.disease
Cardiopulmonary Resuscitation
Confidence interval
Heart Arrest
3. Good health
Surgery
Intensive Care Units
ROC Curve
nervous system
Phosphopyruvate Hydratase
Predictive value of tests
Multivariate Analysis
Ventricular Fibrillation
Ventricular fibrillation
Emergency Medicine
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Resuscitation. 80:165-170
ISSN: 0300-9572
Popis: Summary 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]/μg/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 33 μg/l for NSE at 48 h (sensitivity 43% [28–60%]) and 6.4 μg/l for delta NSE 24–48 h (sensitivity 44% [28–60%]). Conclusion Increase in NSE between 24 and 48 h and NSE at 48 h 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.
Databáze: OpenAIRE
Externí odkaz: