Early Detection and Prognosis Prediction of Severe sepsis and Septic shock in Emergency Triage Room.
- Author:
Sung Hoon BEAK
1
;
Kyoung Mi LEE
;
Dae Young HONG
;
Seung Baik HAN
;
Kang Ho KIM
;
Jun Sig KIM
;
Ji Yoon KIM
;
Ji Hye KIM
;
Hwan Cheol KIM
Author Information
1. Department of Emergency Medicine, Gachon University, Gil Medical center, Incheon, Korea. yongem@gilhospital.com
- Publication Type:Original Article
- Keywords:
S100B protein;
Phosphopyruvate Hydratase;
Heart arrest;
Prognosis
- MeSH:
Biomarkers;
Emergencies;
Heart Arrest;
Humans;
Nerve Growth Factors;
Phosphopyruvate Hydratase;
Prognosis;
Prospective Studies;
Resuscitation;
S100 Proteins;
Sensitivity and Specificity;
Sepsis;
Shock, Septic;
Triage
- From:Journal of the Korean Society of Emergency Medicine
2008;19(6):657-664
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Biochemical markers can help predict neurological outcome in post-resuscitation patients. This prospective study evaluated the prognostic value of serum S100B protein and neuron-specific enolase (NSE) time courses in predicting unfavorable neurological outcomes. METHODS: We serially measured serum S100B protein and NSE levels 12 times during the 96 h after the return of spontaneous circulation (ROSC) in 40 patients. Neurological outcome was assessed at 6 months after cardiac arrest. Patients were divided into good (CPC 1 to 2) and poor (CPC 3 to 5) neurological outcome groups and assessed for cerebral performance category scores. We compared the two groups at each serum value and calculated cut-off values. RESULTS: Serum S100B protein levels over the study period, except at 4 hours, and NSE levels from 14 hours after ROSC were significantly higher in the poor neurological outcome group (n=32) than the good neurological outcome group (n=8). The most predictive serum S100B protein and NSE times were at 14 hours (cut off value=0.16 microgram/L, sensitivity 81.8%, specificity 100%, AUC=0.938) and 54 hours (cut off value=19.21 microgram/L, sensitivity 86.4%, specificity 100%, AUC=0.932). CONCLUSION: Serum S100B protein and NSE levels are early and useful markers for assessing neurological outcome after successful resuscitation from cardiac arrest.
