Sebastian Wiberg1, Jesper Kjaergaard2, Benedict Kjærgaard3, Bjarne Møller4, Bo Nørnberg4, Anne Marie Sørensen5, Christian Hassager6, Michael Wanscher7. 1. Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark; Danish Armed Forces, Health Services, Aarhus, Denmark. Electronic address: sebastian.christoph.wiberg@regionh.dk. 2. Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark. 3. Danish Armed Forces, Health Services, Aarhus, Denmark; Department of Thoracic Surgery, Aalborg University Hospital, Denmark. 4. Danish Armed Forces, Health Services, Aarhus, Denmark. 5. Department of Anaesthesia and Trauma Centre, Centre for Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Denmark. 6. Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark; Department of Cardiology, Odense University Hospital, Denmark. 7. Department of Cardio-Thoracic Anaesthesiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark.
Abstract
AIM: The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30days in patients admitted with severe accidental hypothermia. METHODS: Consecutive patients with severe accidental hypothermia, defined as a core temperature <32°C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO). The day following admission blood was analyzed for NSE and S100b. Follow-up was conducted after 30days and poor neurologic outcome was defined as a Cerebral Performance Category (CPC) score of 3-5. The predictive value of NSE and S100b was assessed as the area under the receiver-operating characteristics curve (AUC). RESULTS: A total of 34 patients were admitted with a diagnosis of severe accidental hypothermia and 29 (85%) were resuscitated from cardiac arrest. ECLS was initiated in 27 (79%) of patients. The day following admission three (9%) patients had died and one (3%) patient was awake, and accordingly, NSE and S100b were analyzed in 30 unconscious and/or sedated patients. NSE and S100b achieved AUCs of 0.93 and 0.88, respectively, for prediction of 30day mortality and AUCs of 0.88 and 0.87, respectively, for prediction of poor neurologic outcome. CONCLUSIONS: In patients remaining unconscious the day following admission for severe accidental hypothermia, the biomarkers NSE and S100b appear to be solid predictors of mortality and poor neurologic outcome after 30days.
AIM: The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30days in patients admitted with severe accidental hypothermia. METHODS: Consecutive patients with severe accidental hypothermia, defined as a core temperature <32°C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO). The day following admission blood was analyzed for NSE and S100b. Follow-up was conducted after 30days and poor neurologic outcome was defined as a Cerebral Performance Category (CPC) score of 3-5. The predictive value of NSE and S100b was assessed as the area under the receiver-operating characteristics curve (AUC). RESULTS: A total of 34 patients were admitted with a diagnosis of severe accidental hypothermia and 29 (85%) were resuscitated from cardiac arrest. ECLS was initiated in 27 (79%) of patients. The day following admission three (9%) patients had died and one (3%) patient was awake, and accordingly, NSE and S100b were analyzed in 30 unconscious and/or sedated patients. NSE and S100b achieved AUCs of 0.93 and 0.88, respectively, for prediction of 30day mortality and AUCs of 0.88 and 0.87, respectively, for prediction of poor neurologic outcome. CONCLUSIONS: In patients remaining unconscious the day following admission for severe accidental hypothermia, the biomarkers NSE and S100b appear to be solid predictors of mortality and poor neurologic outcome after 30days.
Authors: Tom P Aufderheide; Rajat Kalra; Marinos Kosmopoulos; Jason A Bartos; Demetris Yannopoulos Journal: Ann N Y Acad Sci Date: 2021-02-20 Impact factor: 5.691
Authors: Steven T DeKosky; Patrick M Kochanek; Alex B Valadka; Robert S B Clark; Sherry H-Y Chou; Alicia K Au; Christopher Horvat; Ruchira M Jha; Rebekah Mannix; Stephen R Wisniewski; Max Wintermark; Susan E Rowell; Robert D Welch; Lawrence Lewis; Stacey House; Rudolph E Tanzi; Darci R Smith; Amy Y Vittor; Nancy D Denslow; Michael D Davis; Olena Y Glushakova; Ronald L Hayes Journal: J Neurotrauma Date: 2020-11-11 Impact factor: 5.269