Department of Anesthesia and Intensive Care, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Pediatr Cardiol. 2022 Oct;43(7):1659-1665. doi: 10.1007/s00246-022-02899-9. Epub 2022 Apr 16.
The aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict 30 day mortality in children resuscitated from cardiac arrest (CA). It was a prospective observational study at a single tertiary heart centre. Consecutive children were admitted after resuscitated in-hospital and out-of-hospital CA. Levels of NSE and S100b were analyzed from 12 to 24 hours, from 24 to 48 hours, and from 48 to 72 hours after admission. The primary endpoint was 30-day mortality. Differences in biomarker levels between survivors and non-survivors were analyzed with the Mann-Whitney U test. Receiver operating characteristics (ROC) curves were applied to assess the predictive ability of the biomarkers and the areas under the ROC curves (AUC) were presented. A total of 32 resuscitated CA patients were included, and 12 (38%) patients died within 30 days after resuscitation. We observed significantly higher levels of NSE and S100b in non-survivors compared to survivors at all timepoints from 12 to 72 hours after CA. NSE achieved AUCs from 0.91-0.98 for prediction of 30 day mortality, whereas S100b achieved AUCs from 0.93-0.94. An NSE cut-off of 61 μg/L sampled between 12-24 hours from admission achieved a sensitivity of 80% and a specificity of 100% for prediction of 30 day mortality. In children resuscitated from CA, the biomarkers NSE and S100b appear to be solid predictors of mortality after 30 days.
本研究旨在评估神经元特异性烯醇化酶（NSE）和 S100 钙结合蛋白 b（S100b）这两种生物标志物预测心肺复苏后儿童心搏骤停（CA）30 天死亡率的能力。这是一项在单一三级心脏中心进行的前瞻性观察性研究。连续入选在院内和院外 CA 后复苏的儿童。从入院后 12 至 24 小时、24 至 48 小时和 48 至 72 小时分析 NSE 和 S100b 的水平。主要终点为 30 天死亡率。采用 Mann-Whitney U 检验分析幸存者和非幸存者之间生物标志物水平的差异。应用受试者工作特征（ROC）曲线评估生物标志物的预测能力，并呈现 ROC 曲线下面积（AUC）。共纳入 32 例复苏后 CA 患儿，其中 12 例（38%）患儿在复苏后 30 天内死亡。我们观察到，与幸存者相比，非幸存者在 CA 后 12 至 72 小时的所有时间点上的 NSE 和 S100b 水平均显著升高。NSE 对 30 天死亡率的预测 AUC 值为 0.91-0.98，而 S100b 的 AUC 值为 0.93-0.94。入院后 12-24 小时内采样的 NSE 截断值为 61μg/L 时，对 30 天死亡率的预测具有 80%的敏感性和 100%的特异性。在心肺复苏后复苏的儿童中，NSE 和 S100b 这两种生物标志物似乎是 30 天后死亡率的可靠预测指标。
