Article (Scientific journals)
Modeling serum level of s100beta and bispectral index to predict outcome after cardiac arrest.
Stammet, Pascal; Wagner, Daniel R.; Gilson, Georges et al.
2013In Journal of the American College of Cardiology, 62 (9), p. 851-8
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Keywords :
Adult; Aged; Aged, 80 and over; Biomarkers/blood; Brain/physiopathology; Consciousness Monitors; Female; Follow-Up Studies; Heart Arrest/blood/mortality/therapy; Humans; Male; Middle Aged; Nerve Growth Factors/blood; Phosphopyruvate Hydratase/blood; Predictive Value of Tests; Prognosis; Prospective Studies; Resuscitation; Risk Factors; S100 Calcium Binding Protein beta Subunit; S100 Proteins/blood; Sensitivity and Specificity; BIS; CA; CPC; EEG; ICU; IDI; NSE; ROSC; S100beta; SAPS; biomarkers; bispectral index; brain injury; cardiac arrest; cerebral performance category; electroencephalogram; electroencephalography; integrated discrimination improvement; intensive care unit; neuron-enriched S100 beta; neuron-specific enolase; return of spontaneous circulation; simplified acute physiology score; survival
Abstract :
[en] OBJECTIVES: This study was designed to evaluate multimodal prognostication in patients after cardiac arrest (CA). BACKGROUND: Accurate methods to predict outcome after CA are lacking. METHODS: Seventy-five patients with CA treated with therapeutic hypothermia after cardiac resuscitation were enrolled in this prospective observational study. Serum levels of neuron-specific enolase (NSE) and neuron-enriched S100 beta (S100beta) were measured 48 h after CA. Bispectral index (BIS) was continuously monitored during the first 48 h after CA. The primary endpoint was neurological outcome, as defined by the cerebral performance category (CPC) at 6-month follow-up: scores 1 or 2 indicated good outcome, and scores 3 to 5, poor outcome. The secondary endpoint was survival. RESULTS: A total of 46 (61%) patients survived at 6 months and 41 (55%) patients had CPC 1 or 2. Levels of NSE and S100beta were higher in patients with poor outcomes compared with patients with good outcomes (4-fold and 10-fold, respectively; p < 0.001). BIS was lower in patients with poor outcomes (10-fold; p < 0.001). NSE, S100beta, or BIS alone predicted neurological outcome, with areas under the receiver-operating characteristic curve (AUC) above 0.80. Combined determination of S100beta and BIS had an incremental predictive value (AUC: 0.95). S100beta improved discriminations based on BIS (p = 0.0008), and BIS improved discriminations based on S100beta (p < 10(-5)). Patients with S100beta level above 0.03 mug/l and BIS below 5.5 had a 3.6-fold higher risk of poor neurological outcome (p < 0.0001). S100beta and BIS predicted 6-month mortality (log-rank statistic: 50.41; p < 0.001). CONCLUSIONS: Combined determination of serum level of S100beta and BIS monitoring accurately predicts outcome after CA.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Stammet, Pascal ;  Université de Liège - ULiège > Doct. sc. médicales (Bologne)
Wagner, Daniel R.
Gilson, Georges
Devaux, Yvan
Language :
English
Title :
Modeling serum level of s100beta and bispectral index to predict outcome after cardiac arrest.
Publication date :
2013
Journal title :
Journal of the American College of Cardiology
ISSN :
0735-1097
eISSN :
1558-3597
Publisher :
Elsevier, Netherlands
Volume :
62
Issue :
9
Pages :
851-8
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Available on ORBi :
since 24 March 2016

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