Herzog Naemi, Laager Rahel, Thommen Emanuel, Widmer Madlaina, Vincent Alessia M, Keller Annalena, Becker Christoph, Beck Katharina, Perrig Sebastian, Bernasconi Luca, Neyer Peter, Marsch Stephan, Schuetz Philipp, Sutter Raoul, Tisljar Kai, Hunziker Sabina
Department of Medical Communication and Psychosomatic Medicine, University Hospital Basel, 4031 Basel, Switzerland.
Faculty of Medicine, University of Basel, 4031 Basel, Switzerland.
J Clin Med. 2020 May 9;9(5):1405. doi: 10.3390/jcm9051405.
Studies have suggested that taurine may have neuro- and cardio-protective functions, but there is little research looking at taurine levels in patients after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate the association of taurine with mortality and neurological deficits in a well-defined cohort of OHCA patients.
We prospectively measured serum taurine concentration in OHCA patients upon admission to the intensive care unit (ICU) of the University Hospital Basel (Switzerland). We analyzed the association of taurine levels and in-hospital mortality (primary endpoint). We further evaluated neurological outcomes assessed by the cerebral performance category scale. We calculated logistic regression analyses and report odds ratios (OR) and 95% confidence intervals (CI). We calculated different predefined multivariable regression models including demographic variables, comorbidities, initial vital signs, initial blood markers and resuscitation measures. We assessed discrimination by means of area under the receiver operating curve (ROC).
Of 240 included patients, 130 (54.2%) survived until hospital discharge and 110 (45.8%) had a favorable neurological outcome. Taurine levels were significantly associated with higher in-hospital mortality (adjusted OR 4.12 (95%CI 1.22 to 13.91), = 0.02). In addition, a significant association between taurine concentration and a poor neurological outcome was observed (adjusted OR of 3.71 (95%CI 1.13 to 12.25), = 0.03). Area under the curve (AUC) suggested only low discrimination for both endpoints (0.57 and 0.57, respectively).
Admission taurine levels are associated with mortality and neurological outcomes in OHCA patients and may help in the risk assessment of this vulnerable population. Further studies are needed to assess whether therapeutic modulation of taurine may improve clinical outcomes after cardiac arrest.
研究表明,牛磺酸可能具有神经保护和心脏保护功能,但针对院外心脏骤停(OHCA)患者的牛磺酸水平的研究较少。我们的目的是评估在明确的OHCA患者队列中,牛磺酸与死亡率和神经功能缺损之间的关联。
我们前瞻性地测量了瑞士巴塞尔大学医院重症监护病房(ICU)收治的OHCA患者入院时的血清牛磺酸浓度。我们分析了牛磺酸水平与院内死亡率(主要终点)之间的关联。我们进一步评估了通过脑功能分类量表评估的神经学结局。我们进行了逻辑回归分析,并报告了比值比(OR)和95%置信区间(CI)。我们计算了不同的预定义多变量回归模型,包括人口统计学变量、合并症、初始生命体征、初始血液标志物和复苏措施。我们通过受试者操作特征曲线(ROC)下面积评估辨别力。
在纳入的240例患者中,130例(54.2%)存活至出院,110例(45.8%)有良好的神经学结局。牛磺酸水平与较高的院内死亡率显著相关(校正OR 4.12(95%CI 1.22至13.91),P = 0.02)。此外,观察到牛磺酸浓度与不良神经学结局之间存在显著关联(校正OR为3.71(95%CI 1.13至12.25),P = 0.03)。曲线下面积(AUC)表明,对于两个终点的辨别力均较低(分别为0.57和0.57)。
OHCA患者入院时的牛磺酸水平与死亡率和神经学结局相关,可能有助于对这一脆弱人群进行风险评估。需要进一步研究以评估牛磺酸的治疗性调节是否可改善心脏骤停后的临床结局。