Prediction of cognitive dysfunction after resuscitation from out-of-hospital cardiac arrest using serum neuron-specific enolase and protein S-100
| Autor: | Ronan E. O'Carroll, Roy Sherwood, Catriona Simpson, Neil R. Grubb, Stuart M. Cobbe, Keith A.A. Fox, Hagosa D Abraha, Ian J. Deary |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Male
Emergency Medical Services Resuscitation SAMPLE SAMPLES medicine.medical_treatment INVESTIGATE PROTEIN at risk cardiac arrest SERUM memories WHO Information Hospital Mortality Prospective Studies Coma Prospective cohort study time risk Aged 80 and over VALUE S100 Proteins Cognitive disorder Brain Middle Aged IMPAIRMENT Death Predictive value of tests Cardiology method Female patient medicine.symptom Cardiology and Cardiovascular Medicine Adult medicine.medical_specialty Patients Enolase Brain damage Assessment Heart Rhythm Disorders and Pacemakers methods Predictive Value of Tests discharge Memory Internal medicine medicine Humans Cardiopulmonary resuscitation Aged Memory Disorders function business.industry medicine.disease Cardiopulmonary Resuscitation DYSFUNCTION Heart Arrest Surgery predictors Adjustment EVENT Phosphopyruvate Hydratase Multivariate Analysis relationship objective business Prediction Estimation Biomarkers |
| ISSN: | 1355-6037 |
| Popis: | Background: More than 50% of patients initially resuscitated from out-of-hospital cardiac arrest die in hospital. Objective: To investigate the prognostic value of serum protein S-100 and neuron-specific enolase (NSE) concentrations for predicting (a) memory impairment at discharge; (b) in-hospital death, after resuscitation from out-of-hospital cardiac arrest. Methods: In a prospective study of 143 consecutive survivors of out-of-hospital cardiac arrest, serum samples were obtained within 12, 24-48 and 72-96 hours after the event. S-100 and NSE concentrations were measured. Pre-discharge cognitive assessment of patients (n = 49) was obtained by the Rivermead Behavioural Memory Test (RBMT). The relationship between biochemical brain marker concentrations and RBMT scores, and between marker concentrations and the risk of in-hospital death was examined. Results: A moderate negative relationship was found between S-100 concentration and memory test score, at all time points. The relationship between NSE and memory test scores was weaker. An S-100 concentrationgreater than 0.29 ?g/l at time B predicted moderate to severe memory impairment with absolute specificity (42.8% sensitivity). S-100 remained an independent predictor of memory function after adjustment for clinical variables and cardiac arrest timing indices. NSE and S-100 concentrations were greater in patients who died than in those who survived, at all time points. Both NSE and S-100 remained predictors of in-hospital death after adjustment for clinical variables and cardiac arrest timing indices. The threshold concentrations yielding 100% specificity for in-hospital death were S-100: 1.20 ?g/l (sensitivity 44.8%); NSE 71.0 ?g/l (sensitivity 14.0%). Conclusions: Estimation of serum S-100 concentration after out-of-hospital cardiac arrest can be used to identify patients at risk of significant cognitive impairment at discharge. Serum S-100 and NSE concentrations measured 24-48 hours after cardiac arrest provide useful additional information. |
| Databáze: | OpenAIRE |
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