Neuromarkers and neurological outcome in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia-experience from the HAnnover COoling REgistry (HACORE)

Neuron-specific enolase (NSE) and S-100b have been used to assess neurological damage following out-of-hospital cardiac arrest (OHCA). Cut-offs were derived from small normothermic cohorts. Whether similar cut-offs apply to patients treated with hypothermia remained undetermined. We investigated 251...

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Bibliographic Details
Published in:PloS one 2021-01, Vol.16 (1), p.e0245210-e0245210
Main Authors: Akin, Muharrem, Garcheva, Vera, Sieweke, Jan-Thorben, Adel, John, Flierl, Ulrike, Bauersachs, Johann, Schäfer, Andreas
Format: Article
Language:English
Subjects:
Aged
Biology and Life Sciences
Biomarkers
Biomarkers - blood
Cardiac arrest
Cardiology
Care and treatment
Clinical decision making
Cooling
Damage assessment
Decision making
Disease-Free Survival
Emergency medical care
Ethics
Female
Follow-Up Studies
Heart
Humans
Hypothermia
Hypothermia, Induced
Intensive care
Lactic acid
Male
Medical schools
Medicine and Health Sciences
Middle Aged
Mortality
Nervous system diseases
Nervous System Diseases - blood
Nervous System Diseases - mortality
Out-of-Hospital Cardiac Arrest - blood
Out-of-Hospital Cardiac Arrest - mortality
Out-of-Hospital Cardiac Arrest - therapy
Patient outcomes
Patients
Phosphopyruvate hydratase
Phosphopyruvate Hydratase - blood
Physical Sciences
Prospective Studies
Registries
Regression analysis
Rehabilitation
Research and Analysis Methods
Risk factors
S100 Calcium Binding Protein beta Subunit - blood
S100b protein
Sepsis
Survival
Survival Rate
Thresholds
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Summary:Neuron-specific enolase (NSE) and S-100b have been used to assess neurological damage following out-of-hospital cardiac arrest (OHCA). Cut-offs were derived from small normothermic cohorts. Whether similar cut-offs apply to patients treated with hypothermia remained undetermined. We investigated 251 patients with OHCA treated with hypothermia but without routine prognostication. Neuromarkers were determined at day 3, neurological outcome was assessed after hospital discharge by cerebral performance category (CPC). Good neurological outcome (CPC≤2) was achieved in 41%. Elevated neuromarkers, older age and absence of ST-segment elevation after ROSC were associated with increased mortality. Poor neurological outcome in survivors was additionally associated with history of cerebrovascular events, sepsis and higher admission lactate. Mean NSE was 33μg/l [16-94] vs. 119μg/l [25-406]; p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0245210