J Korean Soc Emerg Med.  2008 Dec;19(6):657-664.

Early Detection and Prognosis Prediction of Severe sepsis and Septic shock in Emergency Triage Room

• Beak SH
• Lee KM
• Hong DY
• Han SB
• Kim KH
• Kim JS
• Kim JY
• Kim JH
• Kim HC

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.

Keyword

S100B protein; Phosphopyruvate Hydratase; Heart arrest; Prognosis

MeSH Terms

Biomarkers
Emergencies
Heart Arrest
Humans
Nerve Growth Factors
Phosphopyruvate Hydratase
Prognosis
Prospective Studies
Resuscitation
S100 Proteins
Sensitivity and Specificity
Sepsis
Shock, Septic
Triage
Nerve Growth Factors
Phosphopyruvate Hydratase
S100 Proteins