Related Experiment Video
Updated: Jul 15, 2026
07:18
Mouse Cardiac Arrest Model for Brain Imaging and Brain Physiology Monitoring During Ischemia and Resuscitation
Published on: April 14, 2023
Discordant neuron-specific enolase and neurologic outcomes in out-of-hospital cardiac arrest: a decade-long analysis
Dong Hun Lee1, Seok Jin Ryu1, Byung Kook Lee1
1Department of Emergency Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, the Republic of Korea.
Resuscitation
|July 13, 2026
Summary
Neuron-specific enolase (NSE) levels in out-of-hospital cardiac arrest (OHCA) survivors help predict outcomes. Normal NSE levels indicate poor outcomes are linked to age and systemic issues, while intermediate levels suggest combined insults.
Area of Science:
- Neurology
- Cardiology
- Critical Care Medicine
Background:
- Out-of-hospital cardiac arrest (OHCA) survivors often experience neurological deficits.
- Neuron-specific enolase (NSE) is a biomarker used in prognostication after cardiac arrest.
- Understanding factors influencing outcomes based on NSE levels is crucial for patient management.
Purpose of the Study:
- To characterize clinical profiles of OHCA survivors based on peak NSE concentrations.
- To identify independent clinical determinants of outcomes in patients with discordant NSE levels and neurological status.
Main Methods:
- Retrospective cohort study of 646 comatose adult OHCA survivors (2014-2024) who underwent targeted temperature management.
- Patients categorized into normal (<17 μg/L), intermediate (17-60 μg/L), and high (≥60 μg/L) peak NSE groups.
- Primary endpoint: poor neurological outcome at 6 months (Cerebral Performance Category 3-5); LASSO penalized logistic regression used.
Main Results:
- 193 (29.9%) normal, 182 (28.2%) intermediate, 271 (41.9%) high NSE groups.
- Specificity of peak NSE ≥60 μg/L for poor outcomes was 98.5%.
- In normal NSE group, poor outcomes (26.4%) associated with older age, non-shockable rhythm, non-cardiac etiology, higher PaO2, elevated lactate.
- In intermediate NSE group, poor outcomes (71.4%) associated with non-shockable rhythm, higher SOFA scores, lower gray-to-white matter ratio.
Conclusions:
- In normal NSE patients, poor outcomes are driven by age and systemic derangements.
- In intermediate NSE patients, outcomes reflect hemodynamic insult, organ dysfunction, and cerebral edema.
- A multimodal prognostic approach is essential for OHCA survivors.
