title: Neurological outcome after cardiac arrest: a prospective study of the predictive ability of prognostic biomarkers neuron-specific enolase, glial fibrillary acidic protein, S-100B, and procalcitonin.
abstract: OBJECTIVE
  Factors affecting neurological outcome and the usefulness of neuron-specific enolase (NSE), S-100B, glial fibrillary acidic protein (GFAP), and procalcitonin (PCT) in predicting neurological outcomes were assessed in patients who survived at least 24 h after cardiopulmonary resuscitation (CPR).
  
  
  METHODS
  Thirty successfully resuscitated cardiac arrest patients were included in this prospective clinical study. The initial cardiac arrest rhythm, duration of CPR, return of spontaneous circulation time, administered doses of adrenaline, base excess, blood sugar, and hemodynamic parameters were recorded. Patients with Glasgow Outcome Scale (GOS) scores of 1-3 were defined as Group I and patients with GOS scores of 4-5 were defined as Group II. Serum NSE, GFAP, S-100B, and PCT levels were compared between the two groups shortly after CPR (hour 0) and at hours 12 and 24 of the postresuscitation period.
  
  
  RESULTS
  Serum S-100B was significantly higher (P = 0.009) in Group II immediately after CPR. Serum S-100B and NSE after CPR at hours 0, 12, and 24 were significantly lower in patients who survived to hospital discharge. Serum PCT at hours 12 and 24 and serum S-100B after CPR at 0, 12, and 24 h reached 94.7% sensitivity. Serum NSE, GFAP, S-100B, and PCT specificities were lower than 50%.
  
  
  CONCLUSIONS
  In predicting neurological outcomes, serum S-100B has high sensitivity and low specificity immediately after CPR.
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Gülay
authors.initials: G
authors.lastname: Ok
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Aydın
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Erbüyün
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Gürsoy
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Taneli
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Bilge
authors.affiliation: Department of Biostatistics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey.
authors.forename: Gönül
authors.initials: G
authors.lastname: Dinç Horasan
mesh_terms: D015415:Biomarkers; D002116:Calcitonin; D005904:Glial Fibrillary Acidic Protein; D006323:Heart Arrest; D006801:Humans; D010751:Phosphopyruvate Hydratase; D011379:Prognosis; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit
chemical_list: D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; D064568:S100 Calcium Binding Protein beta Subunit; D002116:Calcitonin; D010751:Phosphopyruvate Hydratase
keywords: Cardiopulmonary resuscitation,; S-100B; glial fibrillary acidic protein; neuron-specific enolase,; procalcitonin