Blood-brain Barrier Disruption As a Cause of Various Serum Neuron-specific Enolase Cut-off Values for Neurological Prognosis in Cardiac Arrest Patients

Overview

Journal Sci Rep

Specialty Science

Date 2022 Feb 10

PMID 35140324

Authors

Changshin Kang

Yeonho You

Hong Joon Ahn

Jung Soo Park

Wonjoon Jeong

Jin Hong Min

Yong Nam In

Insool Yoo

Yongchul Cho

Seung Ryu

Jinwoong Lee

Seung Whan Kim

Affiliations

Soon will be listed here.

Abstract

We compared the cut-off and prognostic value of serum neuron-specific enolase (NSE) between groups with and without severe blood-brain barrier (BBB) disruption to reveal that a cause of various serum NSE cut-off value for neurological prognosis is severe BBB disruption in out-of-hospital cardiac arrest (OHCA) patients underwent target temperature management (TTM). This was a prospective, single-centre study conducted from January 2019 to June 2021. Severe BBB disruption was indicated using cerebrospinal fluid-serum albumin quotient values > 0.02. The area under the receiver operating characteristic curve of serum NSE obtained on day 3 of hospitalisation to predict poor outcomes was used. In patients with poor neurologic outcomes, serum NSE in those with severe BBB disruption was higher than in those without (P = 0.006). A serum NSE cut-off value of 40.4 μg/L for poor outcomes in patients without severe BBB disruption had a sensitivity of 41.7% and a specificity of 96.0%, whereas a cut-off value of 34.6 μg/L in those with severe BBB disruption had a sensitivity of 86.4% and a specificity of 100.0%. We demonstrated that the cut-off and prognostic value of serum NSE were heterogeneous, depending on severe BBB disruption in OHCA patients treated with TTM.

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