Admission interleukin-6 is associated with post resuscitation organ dysfunction and predicts long-term neurological outcome after out-of-hospital ventricular fibrillation

Autor: Jukka, Vaahersalo, Markus B, Skrifvars, Kari, Pulkki, Mats, Stridsberg, Helge, Røsjø, Seppo, Hovilehto, Marjaana, Tiainen, Tero, Varpula, Ville, Pettilä, Esko, Ruokonen, Sinikka, Sälkiö
Rok vydání: 2014
Předmět:
Male
medicine.medical_specialty
Time Factors
Multiple Organ Failure
Ischemia
Emergency Nursing
Return of spontaneous circulation
Risk Assessment
Patient Admission
Predictive Value of Tests
Intensive care
medicine
Humans
Hospital Mortality
Prospective Studies
Interleukin 6
Finland
Aged
biology
business.industry
Interleukin-6
Organ dysfunction
S100 Proteins
Middle Aged
medicine.disease
Prognosis
Survival Analysis
Cardiopulmonary Resuscitation
Surgery
Intensive Care Units
C-Reactive Protein
Logistic Models
Treatment Outcome
Anesthesia
Ventricular fibrillation
Multivariate Analysis
Ventricular Fibrillation
Emergency Medicine
biology.protein
Post resuscitation
Observational study
Female
medicine.symptom
Nervous System Diseases
Cardiology and Cardiovascular Medicine
business
Biomarkers
Out-of-Hospital Cardiac Arrest
Zdroj: Resuscitation. 85(11)
ISSN: 1873-1570
Popis: To study plasma concentrations of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and S-100B during intensive care after out-of-hospital cardiac arrest from ventricular fibrillation (OHCA-VF), and their associations with the duration of ischemia, organ dysfunction and long-term neurological outcome.A 12-month prospective observational multicentre study was conducted in 21 Finnish intensive care units in 2011. IL-6, hs-CRP and S-100B were measured at 0-6 h, 24 h, 48 h and 96 h after ICU admission. Associations with the time to return of spontaneous circulation (ROSC), sequential organ failure assessment (SOFA) scores divided into tertiles and 12-month cerebral performance category (CPC) were tested.Of 186 OHCA-VF patients included in the study, 110 (59.1%) patients survived with good neurological outcome (CPC 1-2) 12 months after cardiac arrest. Admission plasma concentrations of IL-6 but not hs-CRP were higher with prolonged time to ROSC (p0.001, 0.203, respectively), in patients with subsequent higher SOFA scores (p0.001, 0.069) and poor long-term neurological outcome (CPC 3-5) (p0.001, 0.315). S-100B concentrations over time were higher in patients with CPC of 3-5 (p0.001). The area under the curve for prediction of poor 12-month outcome for admission levels was 0.711 IL-6, 0.663 for S-100B and 0.534 for hs-CRP. With multivariate logistic regression analysis only admission IL-6 (p=0.046, OR 1.006, 95% CI 1.000-1.011/ng/L) was an independent predictor of poor neurological outcome.Admission high IL-6, but not hs-CRP or S-100B, is associated with extra-cerebral organ dysfunction and along with age and time to ROSC are independent predictors for 12-month poor neurologic outcome (CPC 3-5).
Databáze: OpenAIRE
Externí odkaz: