Diagnostic Value of Neuron-specific Enolase in Patients with Traumatic Brain Injury Referring to Emergency Departments in 2015-2016

The aim of the present study was to determine the optimal cut-off point ofneuron-specific enolase (NSE) level for diagnosis of brain damage in patients with head trauma.

This cross-sectional study was conducted on 150 patients with traumatic brain injuries (TBIs) who referred to the Emergency Department of Besat Hospital in Tehran, Iran, during 2015-2016. The neuron specific enolase (NSE) serum level was measured by obtaining peripheral blood samples from the participants at two stages, namely upon admission (i.e., the first stage) and 6 h after admission (i.e., the second stage). To determine the best NSE cut-off point, diagnostic indices, such as sensitivity and specificity, as well as positive and negative predictive values, were used by applying the performance curve. Data were analyzed using MedCalc software (version 13.3).

The mean NSE serum levels of the subjects were 16.66 ± 11.32 and 17.92 ± 12.49 at the first and second stages of the study, respectively. The sensitivity and specificity of NES were respectively calculated as 1 and 0.92 at the beginning of the study. In addition, NSE showed significant direct and indirect relationships with computed tomography (CT) scan results and Glasgow Coma Scale (GCS) scores, respectively (P < 0.001).

Considering the NSE cut-off points in the present study, NSE values can be used to determine the brain damage in patients with head trauma based on gender and age group. The NSE showed a high sensitivity and specificity. In addition, an inverse correlation was observed between NSE level and GCS score.