The predictive value of neuron-specific enolase and s-100b protein for neurological outcome in patients with extracorporeal cardiopulmonary resuscitation
10.3760/cma.j.issn.1671-0282.2024.12.007
- VernacularTitle:神经元特异性烯醇化酶、S-100b蛋白对体外心肺复苏患者神经功能预后的预测价值
- Author:
Gannan WANG
1
;
Zhongman ZHANG
;
Huazhong ZHANG
;
Yong MEI
;
Xufeng CHEN
Author Information
1. 南京医科大学第一附属医院急诊科，南京 210029
- Keywords:
Extracorporeal membrane oxygenation;
Cardiopulmonary resuscitation;
Neuron-specific enolase (NSE);
S-100b;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2024;33(12):1704-1709
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the prognostic value of serum levels of neuron-specific enolase (NSE) and S-100b in extracorporeal cardiopulmonary resuscitation (ECPR) patients.Methods:Cardiac arrest (CA) patients whose blood samples were collected at 24 h, 48 h and 72 h after establishment of extracorporeal membrane oxygenation between April 2021 and April 2024 in Emergency Department of the First Affiliated Hospital of Nanjing Medical University were enrolled in this single-center study. The serum levels of NSE and S-100b were measured, and their peak values within 72 h were used for further analysis. The neuro-prognostic values of these two indicators in predicting poor outcomes (Cerebral Performance Category 3-5) were analyzed.Results:Among the 110 patients involved, 81 cases(73.6%) were poor outcomes after ECPR treatment. In the poor-outcome group, serum peak levels of NSE and S-100b were significantly increased ( P < 0.05). Furthermore, the poor-outcome group was divided into CPC 3-4 group and CPC 5 group. The levels of NSE and S-100b in CPC 5 group were significantly higher than those in CPC 1-2 and 3-4 groups ( P < 0.05). NSE levels were significantly lower in CPC 1-2 group than in CPC 3-4 group ( P = 0.048), while no significant differences of S-100b levels were found between the two groups ( P = 0.143). Multivariate logistic regression analysis showed that NSE was an independent risk factor for poor outcomes in ECPR patients ( OR = 1.047, 95% CI: 1.018~1.077, P = 0.001). ROC curve showed that peak levels of NSE ( AUC = 0.843, 95% CI: 0.770~0.915, P < 0.001) and S-100b ( AUC =0.822, 95% CI: 0.739~0.905, P < 0.001) within 72 h had predictive value for poor outcomes in ECPR patients, with optimal cut-off values of 60.14 μg/L and 0.195 μg/L, respectively. Conclusions:The serum peak levels of NSE and S-100b within 72 h after ECMO establishment in ECPR patients are correlated with poor neurological outcomes.
