Department of Anesthesia and Intensive Care I, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.
Surgical Department of "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Cluj, Romania.
PLoS One. 2019 Jan 16;14(1):e0210666. doi: 10.1371/journal.pone.0210666. eCollection 2019.
The aim of our study was to evaluate the potential role of resistin in estimating the 30 days prognosis in patients with hypoxic-ischemic organ injury who survived after a cardiac arrest (CA).
The study included 40 patients resuscitated after a non-traumatic out-of-hospital CA admitted in Emergency Department (ED). All patients were followed for 30 days after CA or until death. Clinical data on admission were recorded. Blood samples were collected on admission in ED (0-time interval), and at 6, 12, 24, 48- and 72-hours following resuscitation. Serum concentrations of resistin, S100B and neuron specific enolase (NSE) were measured. Several predictive scores for the mortality at 30 days were created with logistic regressions.
At each time interval, median serum levels of resistin and S100 B were significantly higher in non-survivors compared to survivors. For NSE, plasma levels were significantly lower in survivors as compared to non-survivors at 48 and 72 hours, respectively. Accurate predictive scores for 30-days mortality were the ones which included the values of resistin and S100B measured at 12 hours after admittance [AUC 0.938 (0.813-0.989), sensitivity 85.71% (67.3%- 96%), specificity 91.67% (61.5%'99.8%), p<0.001], which included the values of all three markers measured at 12 hours after admittance [AUC 0.955 (0.839-0.995), sensitivity 82.14% (63.1%'93.9%), specificity 100.00% (73.5%'100.0%), p<0.001] and the that included the values of resistin and S-100B at 6 hours together with serum lactate on admission [AUC = 0.994 (0.901-1.0), sensitivity 96.4% (81.7%'99.9%), specificity 100.00% (73.5%'100.0%), p<0.001].
In our study, serum levels of resistin or a combination of resistin with S-100B or resistin with S-100B and lactate, were highly predictive for 30 days mortality in resuscitated patients after CA. Further studies on large number of patients are needed to confirm our data.
本研究旨在评估抵抗素在评估心脏骤停（CA）后存活的低氧缺血性器官损伤患者 30 天预后中的潜在作用。
本研究纳入了 40 例在急诊科（ED）接受非创伤性院外 CA 复苏后的患者。所有患者在 CA 后 30 天或直至死亡进行随访。记录入院时的临床数据。入院时在 ED（0 时间间隔）采集血样，并在复苏后 6、12、24、48-72 小时采集。测量血清抵抗素、S100B 和神经元特异性烯醇化酶（NSE）浓度。使用逻辑回归创建了几个用于预测 30 天死亡率的预测评分。
在每个时间间隔，非幸存者的血清抵抗素和 S100B 中位数水平均明显高于幸存者。对于 NSE，与幸存者相比，非幸存者在 48 和 72 小时时的血浆水平明显较低。预测 30 天死亡率的准确预测评分是在入院后 12 小时测量的抵抗素和 S100B 值[AUC 0.938（0.813-0.989），灵敏度 85.71%（67.3%-96%），特异性 91.67%（61.5%-99.8%），p<0.001]，其中包括入院后 12 小时测量的所有三种标志物的值[AUC 0.955（0.839-0.995），灵敏度 82.14%（63.1%-93.9%），特异性 100.00%（73.5%-100.0%），p<0.001]和入院时的抵抗素和 S-100B 值与血清乳酸的联合值[AUC=0.994（0.901-1.0），灵敏度 96.4%（81.7%-99.9%），特异性 100.00%（73.5%-100.0%），p<0.001]。
在我们的研究中，血清抵抗素水平或抵抗素与 S-100B 或抵抗素与 S-100B 和乳酸的联合水平高度预测 CA 后复苏患者 30 天死亡率。需要对更多患者进行进一步研究以证实我们的数据。
