Abstract 313: Neuron-specific Enolase and S-100B Protein in Crebrospinal Fluid: A Study of Sequential Analysis in Cardiac Arrest Patients Who Underwent Target Temperature Management

Abstract

Background: Neuron-specific enolase (NSE) and S-100B protein have been reported that they are associated with neurological outcome in out-of-hospital cardiac arrest (OHCA) survivors. However, comparing the prognostic performance between NSE and S-100B obtained from cerebrospinal fluid (CSF) has not been assessed yet. Therefore, this study aimed to investigate the prognostic performance of NSE and S-100B obtained from CSF for poor neurological outcomes in OHCA survivors. Methods: This was a prospective single-centre observational study, conducted from November 2018 to February 2019. The CSF samples of NSE and S-100B were serially obtained until 72 h from immediate as possible from return of spontaneous circulation (ROSC), at 24 h interval (NSE i , 24,48,72 and S-100B i , 24,48,72 ). The area under curves (AUCs) were used to identify the sensitivities of two biomarkers for predicting poor neurologic outcomes. The primary outcome was the 3-months neurological outcomes. Results: We enrolled 35 patients (males, 28), and 16 subjects had a poor neurologic outcome. NSE and S-100B levels were significantly higher in the poor outcome group compared to the good outcome group at each time point. The AUCs of NSE and S-100B for poor neurological outcomes were 0.87 versus 0.95 at immediately, 0.96 versus 0.92 at 24 h, 0.99 versus 0.97, and 0.98 versus 0.97 at 72 h after ROSC, respectively. The sensitivities with 100% specificity of NSE and S-100B for poor neurological outcomes were 62.5 versus 33.3 at immediate, 73.3 versus 71.4 at 24 h, 92.9 versus 92.3 at 48 h, and 91.7 versus 88.9 at 72 h after ROSC, respectively. Conclusions: S-100B can be useful for early predicting the neurological outcomes of comatose OHCA patients within 24 hours from ROSC in spite of low sensitivity, whereas NSE need 24 hours at least for prognostication. Further prospective with large sample size in multicenter studies are needed to confirm out results.