In a recent study published in the “Systematic Reviews” journal, researchers have delved into the diagnostic and prognostic significance of serum neuron-specific enolase (NSE) levels in patients suffering from sepsis-associated encephalopathy (SAE). By conducting a comprehensive meta-analysis of various studies, the research aims to shed light on the potential role of serum NSE as a biomarker for better understanding and managing SAE.
Study Methodology
The researchers gathered data from English and Chinese databases up to November 2023, focusing on studies reporting serum NSE levels in SAE patients. Information extracted included sample sizes, patient demographics, blood sample collection times, assay methods, and serum NSE levels measured in ng/mL. The quality of the studies was assessed using the QUADAS-2 tool, and the meta-analysis was performed using Review Manager version 5.3, applying either a random effects model or a fixed effects model based on the data. The findings highlighted that serum NSE levels were consistently higher in SAE patients compared to those without encephalopathy, regardless of the detection methods or study designs employed.
Findings and Implications
A total of 17 studies involving 682 SAE patients and 946 non-encephalopathic (NE) patients were included in the meta-analysis. The results demonstrated that serum NSE levels were significantly elevated in SAE patients (Z = 5.97, P < 0.001), with a mean difference of 7.79 ng/mL (95% CI 5.23-10.34). Additionally, SAE patients with favorable outcomes had lower serum NSE levels compared to those with unfavorable outcomes, such as death or adverse neurological effects (Z = 5.44, P < 0.001, MD = -5.34, 95% CI -7.26-3.42).
The study underscores the value of serum NSE as a potential biomarker for diagnosing and predicting outcomes in SAE patients. Elevated NSE levels could indicate severe neurological involvement, thereby guiding clinicians in tailoring treatment strategies. From a market access perspective, the validation of serum NSE as a reliable biomarker could pave the way for the development of new diagnostic kits and therapeutic monitoring tools, enhancing the clinical management of SAE.
Key Inferences
Based on the comprehensive analysis, several concrete inferences can be drawn:
- Serum NSE levels are significantly higher in SAE patients, suggesting its potential as a diagnostic marker.
- Higher serum NSE levels correlate with poorer outcomes, indicating its prognostic value.
- The consistent findings across different study methods and detection techniques bolster the robustness of serum NSE as a biomarker.
- Application of serum NSE measurement in clinical settings could improve patient stratification and treatment planning.
In conclusion, the study highlights the crucial role of serum NSE levels in diagnosing and predicting outcomes in SAE patients. Elevated NSE levels are associated with higher mortality and adverse neurological outcomes, underscoring its potential utility in clinical practice.
Original Article:
Syst Rev. 2024 Jul 22;13(1):191. doi: 10.1186/s13643-024-02583-4.
ABSTRACT
OBJECTIVE: This study aimed to investigate the serum levels of neuron-specific enolase (NSE) in sepsis-associated encephalopathy (SAE) and perform a meta-analysis to assess the diagnostic and prognostic potential of serum NSE in SAE patients.
METHODS: We searched English and Chinese databases for studies related to SAE that reported serum NSE levels until November 2023. We extracted information from these studies including the first author and year of publication, the number of samples, the gender and age of patients, the collection time of blood samples in patients, the assay method of serum NSE, the study methods, and the levels of serum NSE with units of ng/mL. The quality assessment of diagnostic accuracy studies 2 (QUADAS-2) tool was used to evaluate the study quality. A meta-analysis was performed using Review Manager version 5.3, employing either a random effects model or a fixed effects model.
RESULTS: A total of 17 studies were included in the final meta-analysis, including 682 SAE patients and 946 NE patients. The meta-analysis demonstrated significantly higher serum NSE levels in SAE patients compared to NE patients (Z = 5.97, P < 0.001, MD = 7.79, 95%CI 5.23-10.34), irrespective of the method used for serum NSE detection (Z = 6.15, P < 0.001, mean difference [MD] = 7.75, 95%CI 5.28-10.22) and the study methods (Z = 5.97, P < 0.001, MD = 7.79, 95%CI 5.23-10.34). Furthermore, sepsis patients with a favorable outcome showed significantly lower levels of serum NSE compared to those with an unfavorable outcome (death or adverse neurological outcomes) (Z = 5.44, P < 0.001, MD = – 5.34, 95%CI – 7.26-3.42).
CONCLUSION: The Serum level of NSE in SAE patients was significantly higher than that in septic patients without encephalopathy. The higher the serum NSE level in SAE patients, the higher their mortality rate and incidence of adverse neurological outcomes.
PMID:39039544 | DOI:10.1186/s13643-024-02583-4
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