The biomarkers neuron-specific enolase and S100b measured the day following admission for severe accidental hypothermia have high predictive values for poor outcome

TY - JOUR

T1 - The biomarkers neuron-specific enolase and S100b measured the day following admission for severe accidental hypothermia have high predictive values for poor outcome

AU - Wiberg, Sebastian

AU - Kjaergaard, Jesper

AU - Kjærgaard, Benedict

AU - Møller, Bjarne

AU - Nørnberg, Bo

AU - Sørensen, Anne Marie

AU - Hassager, Christian

AU - Wanscher, Michael

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2017/12

Y1 - 2017/12

N2 - Aim The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30 days in patients admitted with severe accidental hypothermia. Methods Consecutive patients with severe accidental hypothermia, defined as a core temperature <32 °C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO). The day following admission blood was analyzed for NSE and S100b. Follow-up was conducted after 30 days and poor neurologic outcome was defined as a Cerebral Performance Category (CPC) score of 3–5. The predictive value of NSE and S100b was assessed as the area under the receiver-operating characteristics curve (AUC). Results A total of 34 patients were admitted with a diagnosis of severe accidental hypothermia and 29 (85%) were resuscitated from cardiac arrest. ECLS was initiated in 27 (79%) of patients. The day following admission three (9%) patients had died and one (3%) patient was awake, and accordingly, NSE and S100b were analyzed in 30 unconscious and/or sedated patients. NSE and S100b achieved AUCs of 0.93 and 0.88, respectively, for prediction of 30 day mortality and AUCs of 0.88 and 0.87, respectively, for prediction of poor neurologic outcome. Conclusions In patients remaining unconscious the day following admission for severe accidental hypothermia, the biomarkers NSE and S100b appear to be solid predictors of mortality and poor neurologic outcome after 30 days.

AB - Aim The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30 days in patients admitted with severe accidental hypothermia. Methods Consecutive patients with severe accidental hypothermia, defined as a core temperature <32 °C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO). The day following admission blood was analyzed for NSE and S100b. Follow-up was conducted after 30 days and poor neurologic outcome was defined as a Cerebral Performance Category (CPC) score of 3–5. The predictive value of NSE and S100b was assessed as the area under the receiver-operating characteristics curve (AUC). Results A total of 34 patients were admitted with a diagnosis of severe accidental hypothermia and 29 (85%) were resuscitated from cardiac arrest. ECLS was initiated in 27 (79%) of patients. The day following admission three (9%) patients had died and one (3%) patient was awake, and accordingly, NSE and S100b were analyzed in 30 unconscious and/or sedated patients. NSE and S100b achieved AUCs of 0.93 and 0.88, respectively, for prediction of 30 day mortality and AUCs of 0.88 and 0.87, respectively, for prediction of poor neurologic outcome. Conclusions In patients remaining unconscious the day following admission for severe accidental hypothermia, the biomarkers NSE and S100b appear to be solid predictors of mortality and poor neurologic outcome after 30 days.

KW - Journal Article

U2 - 10.1016/j.resuscitation.2017.10.006

DO - 10.1016/j.resuscitation.2017.10.006

M3 - Journal article

C2 - 29017847

SN - 0300-9572

VL - 121

SP - 49

EP - 53

JO - Resuscitation

JF - Resuscitation

ER -