Neuron specific enolase and Glasgow motor score remain useful tools for assessing neurological prognosis after out-of-hospital cardiac arrest treated with therapeutic hypothermia - 16/09/15
, Ludovic Palmier a , Benjamin Louart a , Nicolas Molinari b , Pierre-Geraud Claret a , Jean-Emmanuel de la Coussaye a , Jean-Yves Lefrant a , Laurent Muller a Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Aim of the study |
Identifying clinical, electrophysiological and biological predictors for 6-month neurological outcome in survivors at day 3 after cardiac arrest (CA) treated with therapeutic hypothermia (TH).
Methods |
We conducted a retrospective cohort study of adults comatose after out-of hospital CA treated with TH. All data were collected from medical charts and laboratory files.
Results |
Between January 2010 and March 2013, among the 130 analysed CA survivors, 27 (21%) had a good neurological outcome at 6 months and 103 (79%) had a poor neurological outcome, including 98 deaths. The Glasgow coma score motor response (GCS-M), pupillary reflexes and Neuron Specific Enolase (NSE) were the three best predictors of neurological outcome (P<0.0001). The area under the Receiver Operating Characteristic curve for NSE was 0.92 [0.84–0.99].
Conclusion |
NSE values, GCS-M scores and pupillary reflexes are the best predictors of poor 6-month outcome after out-of-hospital CA treated with TH. Of these, NSE values have the best-isolated prognostic performance when above 28.8μg/L.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiac arrest, Prognosis, Therapeutic hypothermia, Neuron-specific enolase
Abbreviations : OHCA, TH, GCS-M, CPC, NSE, SSEP, ICU, ROC curve, EEG, EoL
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Vol 34 - N° 4
P. 231-237 - août 2015 Retour au numéro
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