Acute cardiac care & resuscitation
Degree of neurological recovery as a function of initial neuron-specific enolase levels and electroencephalographic patterns in survivors of cardiac arrest: a bicentric study
Authors' conclusion
This large bicentric study found a progressive worsening of neurological outcomes at 3 months with higher NSE levels or deteriorating EEG patterns.
Study context
- Population
- Comatose patients after cardiac arrest with serum NSE at 48 h and EEG ≥ 24 h (CHUV Lausanne, Switzerland; Cochin Hospital, France), 2017–2024
- Participants
- 966 patients
- Exposure
- NSE levels at 48 h and EEG patterns across Cerebral Performance Category (CPC) groups at 3 months
- Outcome
- Level of neurological recovery by Cerebral Performance Category (CPC) scale
- Follow-up
- 3 months
Methodological detailstwo prospective registries, bicentric
- Two prospective registries
- Bicentric
Main finding
As reported in the abstract
NSE level ranges at 48 h differed significantly across CPC groups, higher values associated with poorer functional outcomes; also in survivors (CPC1 vs CPC2 vs CPC3)
p < 0.001
EEG patterns differed significantly across CPC groups: the more severe the EEG pattern, the worse the functional outcome
p < 0.001
Observational data: associations, not effects.
Further findings
False-positive prediction of unfavourable outcome: NSE > 60 µg/L in patients with favourable outcome · 3 months
Maximum NSE CPC 1 79.5 µg/L · CPC 2 68 µg/L
- False-positive prediction of unfavourable outcome: NSE > 60 µg/L in patients with favourable outcome: CPC 1: 2/176; CPC 2: 3/138
False-positive prediction of unfavourable outcome: NSE > 60 µg/L in patients with favourable outcome · 3 months
- None of them had other markers of unfavourable outcome
Highly malignant EEG in patients with CPC 1 or 2 · 3 months
- No patients with CPC 1 or 2 had a highly malignant EEG
Original publication
Summarised from the published abstract; every number is checked against it