Comparison of the predictability of neurological outcome by serum procalcitonin and glial fibrillary acidic protein in postcardiac-arrest patients.
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.
Hayashida
Hiromi
H
Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan.
Kaneko
Tadashi
T
Kasaoka
Shunji
S
Oshima
Chiyomi
C
Miyauchi
Takashi
T
Fujita
Motoki
M
Oda
Yasutaka
Y
Tsuruta
Ryosuke
R
Maekawa
Tsuyoshi
T
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
C000606589:CALCA protein, human; D005904:Glial Fibrillary Acidic Protein; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide