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Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C
BACKGROUND: We aimed to investigate the diagnostic performance of S100 as an outcome predictor after out-of-hospital cardiac arrest (OHCA) and the potential influence of two target temperatures (33 °C and 36 °C) on serum levels of S100. METHODS: This is a substudy of the Target Temperature Managemen...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477102/ https://www.ncbi.nlm.nih.gov/pubmed/28629472 http://dx.doi.org/10.1186/s13054-017-1729-7 |
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author | Stammet, Pascal Dankiewicz, Josef Nielsen, Niklas Fays, François Collignon, Olivier Hassager, Christian Wanscher, Michael Undèn, Johan Wetterslev, Jorn Pellis, Tommaso Aneman, Anders Hovdenes, Jan Wise, Matt P. Gilson, Georges Erlinge, David Horn, Janneke Cronberg, Tobias Kuiper, Michael Kjaergaard, Jesper Gasche, Yvan Devaux, Yvan Friberg, Hans |
author_facet | Stammet, Pascal Dankiewicz, Josef Nielsen, Niklas Fays, François Collignon, Olivier Hassager, Christian Wanscher, Michael Undèn, Johan Wetterslev, Jorn Pellis, Tommaso Aneman, Anders Hovdenes, Jan Wise, Matt P. Gilson, Georges Erlinge, David Horn, Janneke Cronberg, Tobias Kuiper, Michael Kjaergaard, Jesper Gasche, Yvan Devaux, Yvan Friberg, Hans |
author_sort | Stammet, Pascal |
collection | PubMed |
description | BACKGROUND: We aimed to investigate the diagnostic performance of S100 as an outcome predictor after out-of-hospital cardiac arrest (OHCA) and the potential influence of two target temperatures (33 °C and 36 °C) on serum levels of S100. METHODS: This is a substudy of the Target Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) trial. Serum levels of S100 were measured a posteriori in a core laboratory in samples collected at 24, 48, and 72 h after OHCA. Outcome at 6 months was assessed using the Cerebral Performance Categories Scale (CPC 1–2 = good outcome, CPC 3–5 = poor outcome). RESULTS: We included 687 patients from 29 sites in Europe. Median S100 values were higher in patients with a poor outcome at 24, 48, and 72 h: 0.19 (IQR 0.10–0.49) versus 0.08 (IQR 0.06–0.11) μg/ml, 0.16 (IQR 0.10–0.44) versus 0.07 (IQR 0.06–0.11) μg/L, and 0.13 (IQR 0.08–0.26) versus 0.06 (IQR 0.05–0.09) μg/L (p < 0.001), respectively. The ability to predict outcome was best at 24 h with an AUC of 0.80 (95% CI 0.77–0.83). S100 values were higher at 24 and 72 h in the 33 °C group than in the 36 °C group (0.12 [0.07–0.22] versus 0.10 [0.07–0.21] μg/L and 0.09 [0.06–0.17] versus 0.08 [0.05–0.10], respectively) (p < 0.02). In multivariable analyses including baseline variables and the allocated target temperature, the addition of S100 improved the AUC from 0.80 to 0.84 (95% CI 0.81–0.87) (p < 0.001), but S100 was not an independent outcome predictor. Adding S100 to the same model including neuron-specific enolase (NSE) did not further improve the AUC. CONCLUSIONS: The allocated target temperature did not affect S100 to a clinically relevant degree. High S100 values are predictive of poor outcome but do not add value to present prognostication models with or without NSE. S100 measured at 24 h and afterward is of limited value in clinical outcome prediction after OHCA. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01020916. Registered on 25 November 2009. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-017-1729-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5477102 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-54771022017-06-22 Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C Stammet, Pascal Dankiewicz, Josef Nielsen, Niklas Fays, François Collignon, Olivier Hassager, Christian Wanscher, Michael Undèn, Johan Wetterslev, Jorn Pellis, Tommaso Aneman, Anders Hovdenes, Jan Wise, Matt P. Gilson, Georges Erlinge, David Horn, Janneke Cronberg, Tobias Kuiper, Michael Kjaergaard, Jesper Gasche, Yvan Devaux, Yvan Friberg, Hans Crit Care Research BACKGROUND: We aimed to investigate the diagnostic performance of S100 as an outcome predictor after out-of-hospital cardiac arrest (OHCA) and the potential influence of two target temperatures (33 °C and 36 °C) on serum levels of S100. METHODS: This is a substudy of the Target Temperature Management after Out-of-Hospital Cardiac Arrest (TTM) trial. Serum levels of S100 were measured a posteriori in a core laboratory in samples collected at 24, 48, and 72 h after OHCA. Outcome at 6 months was assessed using the Cerebral Performance Categories Scale (CPC 1–2 = good outcome, CPC 3–5 = poor outcome). RESULTS: We included 687 patients from 29 sites in Europe. Median S100 values were higher in patients with a poor outcome at 24, 48, and 72 h: 0.19 (IQR 0.10–0.49) versus 0.08 (IQR 0.06–0.11) μg/ml, 0.16 (IQR 0.10–0.44) versus 0.07 (IQR 0.06–0.11) μg/L, and 0.13 (IQR 0.08–0.26) versus 0.06 (IQR 0.05–0.09) μg/L (p < 0.001), respectively. The ability to predict outcome was best at 24 h with an AUC of 0.80 (95% CI 0.77–0.83). S100 values were higher at 24 and 72 h in the 33 °C group than in the 36 °C group (0.12 [0.07–0.22] versus 0.10 [0.07–0.21] μg/L and 0.09 [0.06–0.17] versus 0.08 [0.05–0.10], respectively) (p < 0.02). In multivariable analyses including baseline variables and the allocated target temperature, the addition of S100 improved the AUC from 0.80 to 0.84 (95% CI 0.81–0.87) (p < 0.001), but S100 was not an independent outcome predictor. Adding S100 to the same model including neuron-specific enolase (NSE) did not further improve the AUC. CONCLUSIONS: The allocated target temperature did not affect S100 to a clinically relevant degree. High S100 values are predictive of poor outcome but do not add value to present prognostication models with or without NSE. S100 measured at 24 h and afterward is of limited value in clinical outcome prediction after OHCA. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01020916. Registered on 25 November 2009. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-017-1729-7) contains supplementary material, which is available to authorized users. BioMed Central 2017-06-20 /pmc/articles/PMC5477102/ /pubmed/28629472 http://dx.doi.org/10.1186/s13054-017-1729-7 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Stammet, Pascal Dankiewicz, Josef Nielsen, Niklas Fays, François Collignon, Olivier Hassager, Christian Wanscher, Michael Undèn, Johan Wetterslev, Jorn Pellis, Tommaso Aneman, Anders Hovdenes, Jan Wise, Matt P. Gilson, Georges Erlinge, David Horn, Janneke Cronberg, Tobias Kuiper, Michael Kjaergaard, Jesper Gasche, Yvan Devaux, Yvan Friberg, Hans Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C |
title | Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C |
title_full | Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C |
title_fullStr | Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C |
title_full_unstemmed | Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C |
title_short | Protein S100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °C and 36 °C |
title_sort | protein s100 as outcome predictor after out-of-hospital cardiac arrest and targeted temperature management at 33 °c and 36 °c |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477102/ https://www.ncbi.nlm.nih.gov/pubmed/28629472 http://dx.doi.org/10.1186/s13054-017-1729-7 |
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