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KMID : 0385920080190060648
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Journal of the Korean Society of Emergency Medicine
2008 Volume.19 No. 6 p.648 ~ p.656
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Serum S100B Protein and Neuron- Specific Enolase: Time Course and Usefulness as Predictors of Neurological Outcome in Post-resuscitaion Patients
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Park Sung-Wook
Lim Yong-Su
Kim Jin-Joo
Kim Jae-Kwang
Yang Hyuk-Jun
Hyun Sung-Youl
Ryoo Eell
Sung Ae-Jin
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Abstract
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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 μg/L, sensitivity 81.8%, specificity 100%, AUC=0.938) and 54 hours (cut off value=19.21 μg/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.
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KEYWORD
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S100B protein, Phosphopyruvate Hydratase, Heart arrest, Prognosis
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