Table 3.
Comparison of NSE levels to predict poor outcome after cardiac arrest and referenced study profiles
| Référence | In-hospital CPR (%) | Time of inclusion after CPR, n |
Hypothermic therapy, n |
Follow-up | Poor outcome definition, and number n |
Method used for NSE measurement | NSE sampling time | Cut-off value (ng/mL) | Se | Sp |
|---|---|---|---|---|---|---|---|---|---|---|
| Fogel et al. [10] 1997 |
Not specified | ICU admission n = 43 |
No | 3 months | Remained comatose n = 25 |
Radioimmunoassay, Pharmacia LKB | Day 0 Day 1 Day 2 Day 3 |
33 33 33 33 |
25 60 63 65 |
100 100 100 100 |
| Martens et al. [21] 1998 |
Not specified | > 24 h n = 64 |
No | 6 months | Remained comatose n = 35 |
Radioimmunoassay, Profilogen | 24 h | 20 | 51 | 89 |
| Schoerkhber et al. [11] 1999 | Yes (not specified) | > 6 h n = 56 |
No | 6 months | CPC 3-5 n = 28 |
Radioimmunoassay, Profilogen | 12 h 24 h 48 h 72 h Peak NSE level 12-72 h |
38 40 25 17 27 |
18 8 48 70 29 |
100 100 100 100 100 |
| Rosen et al. [12] 2001 |
No | > 24 h n = 66 |
No | 1 year | CPC 3-5 n = 42 |
Imunoluminometric assay, Byk Sangtec Diagnostica | Day1 Day2 Day3 |
25 25 25 |
NM NM NM |
100 100 100 |
|
Zingler et al. [15]2003 |
Yes (not specified) | ICU admission n = 27 |
No | 3 months |
CPC 4-5 n = 17 |
Immunoluminometric assay, Byk Sangtec Diagnostica | Day1 Day2 Day3 Day7 |
48 43 91 39 |
53 91 75 57 |
100 100 100 100 |
| Tiainem et al. [14] 2003 |
No* | ICU admission n = 70 |
Yes n = 36 |
6 months | CPC 3-5 n = 29 |
time-resolved immunofluorometric assay (DELFIA, Wallac) | 24 h HT/no HT 36 h HT/no HT 48 h HT/no HT |
31/13 26/13 25/9 |
22/59 30/63 25/76 |
96/100 96/100 96/100 |
| Meynaar et al. [13] 2003 |
Yes (23%) | ICU admission n = 110 |
No | Hospital discharge |
Remained comatose n = 81 |
time-resolved immunofluorometric assay (DELFIA, Wallac) | Peak NSE level 24-48 h¶ | 25 | 59 | 100 |
|
Pfeifer et al. [16]2005 |
Yes (44%) | > 48 h n = 97 |
Not specified | Day 28 |
CPC 4-5 n = 70 |
Imunoluminometric assays, Byk Sangtec Diagnostica | Day 3 | 65 | 50 | 96 |
|
Rech at al. [17]2006 |
Yes (100%) | >12 h n = 45 |
No | 6 months |
CPC 4-5 n = 34 |
Electrochemiluminescence immunoassay, Roche Mannheim | Between 12-36 h | 60 | 35 | 100 |
|
Zandbergen et al [2]2006 |
Not specified | > 24 h n = 407 |
Yes (not specified) | 1 months | CPC 4-5 n = 356 |
Immunoluminometric assay, Byk Sangtec Diagnostica | 24 h 48 h 72 h |
>33 >33 >33 |
42 52 46 |
100 100 100 |
| Auer et al. [18] 2006 |
Yes (not specified) | n = 17 | Not specified | Hospital discharge |
Death n = 9 |
Electrochemiluminescence immunoassay, Roche Mannheim | 48 h | 30 | 79 | 100 |
| Grubb et al. [23] 2007 |
No | ICU admission n = 143 |
Not specified | Hospital discharge |
Death |
Enzyme immunoassay, Roche Diagnostics | 12 h 24-48 h 72-96 h |
NM 71 NM |
14 | 100 |
|
Reisinger et al. [19]2007 |
Yes (44%) | ICU admission n = 177 |
Yes n = 20 |
6 months |
CPC 4-5 n = 59 |
Electrochemiluminescence immunoassay, Roche Mannheim | Peak NSE level Day 0-4 |
80 | 63 | 100 |
| Oksanen et al. [20] 2009 |
No* | ICU admission n = 90 |
Yes n = 90 |
6 months | CPC 3-5 n = 40 |
Electrochemiluminescence immunoassay, Roche Mannheim | 24 h 48 h |
41 33 |
20 43 |
100 100 |
| Rundgren et al. [9] 2009 |
Yes (17%) | ICU admission n = 102 (for NSE cohort) |
Yes n = 102 |
6 months | CPC 3-5 n = 46 |
Imunoluminometric assay, DiaSorin | 2 h 24 h 48 h 72 h |
31 38 28 27 |
6 11 67 50 |
100 100 100 100 |
| Shinozaki et al. [22] 2009 |
Yes (27%) | ICU admission n = 80 |
Yes n = 45 |
6 months | CPC 3-5 n = 67 |
Immunoradiometric assay, Profilogen, DiaSorin | Admission 6 h 24 h |
46 66 40 |
14 19 72 |
100 100 100 |
| Steffen et al [42] 2010 |
Yes (21%) | ICU admission n = 240 |
Yes n = 133 |
ICU discharge |
CPC 3-5 n = 147 |
Electrochemiluminescence immunoassay, Roche Mannheim | 72 h HT/no HT | 79/27 | 50 80 |
100 100 |
| Present study | Yes (31%) |
> 48 h n = 97 |
Yes n = 65 |
3 months |
CPC 4-5 n = 72 |
Electrochemiluminescence immunoassay, Roche Mannheim | Peak NSE level 24-72 h | 97 | 49 | 100 |
HT; hypothermic therapy, NM; not mentioned
* Only ventricular fibrillation as initial rhythm was eligible for the study
¶ Results mentioned only for patients who remained comatose 48 hours after CPR (n = 67)