Trial reportPloS one2017
Single versus Serial Measurements of Neuron-Specific Enolase and Prediction of Poor Neurological Outcome in Persistently Unconscious Patients after Out-Of-Hospital Cardiac Arrest - A TTM-Trial Substudy.
Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01020916 (Target Temperature Management 33°C Versus 36°C After Out-of-hospital Cardiac Arrest, a Randomised, Parallel Groups, Assessor Blinded Clinical Trial), which is not on this map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Target Temperature Management 33°C Versus 36°C After Out-of-hospital Cardiac Arrest, a Randomised, Parallel Groups, Assessor Blinded Clinical Trial
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Neuron-Specific Enolase as a Biomarker for Selected Neurological and Psychiatric Disorders-A Systematic Review of the Literature.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Prediction of poor neurological outcome in comatose survivors of cardiac arrest: a systematic review.Intensive care medicine · 2020Pooled it
- Application of Phosphorylated Tau for Predicting Outcomes Among Sudden Cardiac Arrest Survivors.Neurocritical care · 2025Article
- Personalized neuron-specific enolase level based on EEG pattern for prediction of poor outcome after cardiac arrest.Annals of intensive care · 2025Article
- The Glasgow Coma Scale and Full Outline of Unresponsiveness score evaluation to predict patient outcomes with neurological illnesses in intensive care units in West Bank: a prospective cross-sectional study.Acute and critical care · 2024Article
- Validation of neuron-specific enolase in cardiac arrest patients with limited withdrawal of life-sustaining therapy.Heliyon · 2024Article
- Neuron-specific enolase in hypertension patients with acute ischemic stroke and its value forecasting long-term functional outcomes.BMC geriatrics · 2023Article
- The Value of the Biomarkers Neuron-Specific Enolase and S100 Calcium-Binding Protein for Prediction of Mortality in Children Resuscitated After Cardiac Arrest.Pediatric cardiology · 2022Observational
- Increased plasma disequilibrium between pro- and anti-oxidants during the early phase resuscitation after cardiac arrest is associated with increased levels of oxidative stress end-products.Molecular medicine (Cambridge, Mass.) · 2021Article
- Ultra-early serum concentrations of neuronal and astroglial biomarkers predict poor neurological outcome after out-of-hospital cardiac arrest-a pilot neuroprognostic study.Resuscitation plus · 2021Article
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care.Intensive care medicine · 2021Article
- Neurofilament to predict post-anoxic neurological outcome: are we ready for the prime time?Intensive care medicine · 2021Article
- Neurofilament light as an outcome predictor after cardiac arrest: a post hoc analysis of the COMACARE trial.Intensive care medicine · 2021Article
- Postcardiac Arrest Neuroprognostication Practices: A Survey of Brazilian Physicians.Critical care explorations · 2021Article
- Monosialotetrahexosylganglioside sodium combined with hyperbaric oxygen on nervous system development and brain physiology in children with hypoxic ischemic encephalopathy.American journal of translational research · 2021Article
- Resuscitating the Globally Ischemic Brain: TTM and Beyond.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Association between Achievement of Estimated Average Glucose Level and 6-Month Neurologic Outcome in Comatose Cardiac Arrest Survivors: A Propensity Score-Matched Analysis.Journal of clinical medicine · 2019Article
- Article
- Resistin-Can it be a new early marker for prognosis in patients who survive after a cardiac arrest? A pilot study.PloS one · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 14 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrediction of neurological outcome is a crucial part of post cardiac arrest care and prediction in patients remaining unconscious and/or sedated after rewarming from targeted temperature management (TTM) remains difficult. Current guidelines suggest the use of serial measurements of the biomarker neuron-specific enolase (NSE) in combination with other predictors of outcome in patients admitted after out-of-hospital cardiac arrest (OHCA). This study sought to investigate the ability of NSE to predict poor outcome in patients remaining unconscious at day three after OHCA. In addition, this study sought to investigate if serial NSE measurements add incremental prognostic information compared to a single NSE measurement at 48 hours in this population.
methodsThis study is a post-hoc sub-study of the TTM trial, randomizing OHCA patients to a course of TTM at either 33°C or 36°C. Patients were included from sites participating in the TTM-trial biobank sub study. NSE was measured at 24, 48 and 72 hours after ROSC and follow-up was concluded after 180 days. The primary end point was poor neurological function or death defined by a cerebral performance category score (CPC-score) of 3 to 5.
resultsA total of 685 (73%) patients participated in the study. At day three after OHCA 63 (9%) patients had died and 473 (69%) patients were not awake. In these patients, a single NSE measurement at 48 hours predicted poor outcome with an area under the receiver operating characteristics curve (AUC) of 0.83. A combination of all three NSE measurements yielded the highest discovered AUC (0.88, p = .0002). Easily applicable combinations of serial NSE measurements did not significantly improve prediction over a single measurement at 48 hours (AUC 0.58-0.84 versus 0.83).
conclusionNSE is a strong predictor of poor outcome after OHCA in persistently unconscious patients undergoing TTM, and NSE is a promising surrogate marker of outcome in clinical trials. While combinations of serial NSE measurements may provide an increase in overall prognostic information, it is unclear whether actual clinical prognostication with low false-positive rates is improved by application of serial measurements in persistently unconscious patients. The findings of this study should be confirmed in another prospective cohort.
trial registrationNCT01020916.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.