{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:10:41Z","timestamp":1790892641456,"version":"4.1.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"crossref","award":["Clinical Research Group (KFO) 311, TP1"],"award-info":[{"award-number":["Clinical Research Group (KFO) 311, TP1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Neuron-specific enolase (NSE) and S-100b have been used to assess neurological damage following out-of-hospital cardiac arrest (OHCA). Cut-offs were derived from small normothermic cohorts. Whether similar cut-offs apply to patients treated with hypothermia remained undetermined.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We investigated 251 patients with OHCA treated with hypothermia but without routine prognostication. Neuromarkers were determined at day 3, neurological outcome was assessed after hospital discharge by cerebral performance category (CPC).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Good neurological outcome (CPC\u22642) was achieved in 41%. Elevated neuromarkers, older age and absence of ST-segment elevation after ROSC were associated with increased mortality. Poor neurological outcome in survivors was additionally associated with history of cerebrovascular events, sepsis and higher admission lactate. Mean NSE was 33\u03bcg\/l [16\u201394] vs. 119\u03bcg\/l [25\u2013406]; p&lt;0.001, for survivors vs. non-survivors, and 21\u03bcg\/l [16\u201329] vs. 40\u03bcg\/l [23\u201398], p&lt;0.001 for good vs. poor neurological outcome. S-100b was 0.127\u03bcg\/l [0.063\u20130.360] vs. 0.772\u03bcg\/l [0.121\u20132.710], p&lt;0.001 and 0.086\u03bcg\/l [0.061\u20130.122] vs. 0.138\u03bcg\/l [0.090\u20130.271], p = 0.009, respectively. For mortality, thresholds of 36\u03bcg\/l for NSE and 0.128\u03bcg\/l for S-100b could be determined; for poor neurological outcome 33\u03bcg\/l (NSE) and 0.123\u03bcg\/l (S-100b), respectively. Positive predictive value for NSE was 81% (74\u201388) and 79% (71\u201385) for S-100b.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Thresholds for NSE and S-100b predicting mortality and poor neurological outcome are similar in OHCA patients receiving therapeutic hypothermia as in those reported before the era of hypothermia. However, both biomarkers do not have enough specificity to predict mortality or poor neurological outcome on their own and should only be additively used in clinical decision making.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0245210","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T23:27:03Z","timestamp":1610062023000},"page":"e0245210","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["Neuromarkers and neurological outcome in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia\u2013experience from the HAnnover COoling REgistry (HACORE)"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0936-8755","authenticated-orcid":true,"given":"Muharrem","family":"Akin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Garcheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Thorben","family":"Sieweke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Adel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Flierl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Bauersachs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"issue":"2","key":"pone.0245210.ref001","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1227\/00006123-198708000-00007","article-title":"Moderate hypothermia reduces postischemic edema development and leukotriene production","volume":"21","author":"RJ Dempsey","year":"1987","journal-title":"Neurosurgery"},{"issue":"8","key":"pone.0245210.ref002","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1056\/NEJMoa012689","article-title":"Hypothermia after Cardiac Arrest Study G. 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