title: Comparison of the predictability of neurological outcome by serum procalcitonin and glial fibrillary acidic protein in postcardiac-arrest patients.
abstract: BACKGROUND
  In past research, procalcitonin (PCT) and glial fibrillary acidic protein (GFAP) have been reported to be useful biomarkers in predicting neurological outcome after the return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (CA), although they have only been studied separately. In this study, we compared the usefulness of PCT and GFAP in predicting neurological outcome.
  
  
  METHODS
  This study was a retrospective, single-center analysis, conducted in the intensive-care unit of a university hospital. Twenty-one sequential post-CA patients were included. Serum samples were collected from patients at 12 and 24 h after ROSC. Serum PCT and GFAP were measured and compared in patients with favorable and unfavorable neurological outcomes, evaluated at 6 months using the Glasgow-Pittsburgh Cerebral Performance Categories.
  
  
  RESULTS
  Serum PCT was significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.004 and 0.002, respectively). Serum GFAP was not significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.118 and 0.079, respectively). The combination of PCT and GFAP showed high predictive value for unfavorable outcomes (86.7% sensitivity and 100% specificity at 12 h; 100% sensitivity and 83.3% specificity at 24 h).
  
  
  CONCLUSIONS
  Serum PCT is a marker of unfavorable neurological outcome in post-CA patients, and is superior to serum GFAP in the early phase.
authors.affiliation: Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hayashida
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kaneko
authors.forename: Shunji
authors.initials: S
authors.lastname: Kasaoka
authors.forename: Chiyomi
authors.initials: C
authors.lastname: Oshima
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyauchi
authors.forename: Motoki
authors.initials: M
authors.lastname: Fujita
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Oda
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tsuruta
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Maekawa
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016887:Cardiopulmonary Resuscitation; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000097:blood*; D006323:Heart Arrest / Q000097:blood* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: C000606589:CALCA protein, human; D005904:Glial Fibrillary Acidic Protein; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide