Prognostic Value and Optimal Sampling Time of S-100B Protein for Outcome Prediction in Cardiac Arrest Patients Treated with Therapeutic Hypothermia.
10.4266/kjccm.2014.29.4.304
- Author:
Hyung Seok KIM
;
Ho Sung JUNG
;
Yong Su LIM
;
Jae Hyug WOO
;
Jae Ho JANG
;
Jee Yong JANG
;
Hyuk Jun YANG
- Publication Type:Original Article
- Keywords:
cardiac arrest;
hypothermia;
S100 calcium binding protein beta subunit
- MeSH:
Area Under Curve;
Heart Arrest*;
Humans;
Hypothermia*;
Prospective Studies;
ROC Curve;
S100 Calcium Binding Protein beta Subunit*;
Sensitivity and Specificity
- From:Korean Journal of Critical Care Medicine
2014;29(4):304-312
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
