Serum S-100B and interleukin-8 as predictive markers for comparative neurologic outcome analysis of patients after cardiac arrest and severe traumatic brain injury.
OBJECTIVE
To compare S-100B and interleukin-8 serum values on scene/at admission and 12 hrs later with respect to neurologic long-term outcome 12 months after cardiac arrest and return of spontaneous circulation, as well as after severe traumatic brain injury.


METHODS
Prospective comparative cohort study.


METHODS
On scene; intensive care units of a university hospital.


METHODS
Twenty patients with out-of-hospital cardiac arrest. Twenty patients with severe traumatic brain injury.


METHODS
Therapy was adjusted to the standards of modern prehospital and intensive care management by physicians who were not involved in the study.


RESULTS
First median S-100B values of the cardiac arrest group (4.42 ng/mL) mounted as high as those of the traumatic brain injury group (4.11 ng/mL). Within 12 hrs, S-100B levels significantly decreased to 0.75 ng/mL in cardiac arrest patients and to 0.68 ng/mL in traumatic brain injury patients but remained significantly elevated compared with the controls (0.04 ng/mL). Interleukin-8 levels of the cardiac arrest patients on scene (30.33 pg/mL) were clearly elevated above normal (12.60 pg/mL) and increased significantly to 101.40 pg/mL after 12 hrs. They showed no significant difference compared with those of the traumatic brain injury patients (78.75 pg/mL and 96.00 pg/mL, respectively). Multivariate Cox regression analysis in cardiac arrest patients identified only the S-100B level measured 12 hrs after study entry as an independent predictor for unfavorable neurologic outcome according to the Glasgow Outcome Scale score. In contrast, S-100B as well as interleukin-8 levels quantified 12 hrs after admission significantly predicted an unfavorable neurologic course in the traumatic brain injury group.


CONCLUSIONS
Significantly elevated S-100B and interleukin-8 serum levels 12 hrs after cardiac arrest suggest that primary brain damage and systemic inflammatory response are comparably serious with that of traumatic brain injury. In both collectives, increased S-100B values measured 12 hrs after insult correlated well with an unfavorable neurologic outcome after 12 months.
Mussack
Thomas
T
Chirurgische Klinik und Poliklinik Innenstadt, Klinikum der Universitat Munchen, Munich, Germany.
Biberthaler
Peter
P
Kanz
Karl-Georg
KG
Wiedemann
Ernst
E
Gippner-Steppert
Cornelia
C
Mutschler
Wolf
W
Jochum
Marianne
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001930:Brain Injuries / Q000175:diagnosis*; D016022:Case-Control Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D023261:Glasgow Outcome Scale; D006323:Heart Arrest / Q000175:diagnosis*; D006801:Humans; D016209:Interleukin-8 / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009414:Nerve Growth Factors; D011446:Prospective Studies; D012372:ROC Curve; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D015415:Biomarkers; D016209:Interleukin-8; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins