Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/9214
Appears in Collections:Psychology Journal Articles
Peer Review Status: Refereed
Title: Prediction of cognitive dysfunction after resuscitation from out-of-hospital cardiac arrest using serum neuron-specific enolase and protein S-100
Authors: Grubb, Neil R
Simpson, Catriona
Sherwood, Roy A
Abraha, Hagosa D
Cobbe, Stuart M
O'Carroll, Ronan
Deary, Ian
Fox, Keith A A
Contact Email: ronan.ocarroll@stir.ac.uk
Keywords: Adjustment
Assessment
at risk
Brain
cardiac arrest
Death
discharge
DYSFUNCTION
Estimation
EVENT
function
IMPAIRMENT
Information
INVESTIGATE
memories
Memory
method
methods
objective
patient
Patients
Prediction
predictors
Prospective Studies
PROTEIN
relationship
risk
SAMPLE
SAMPLES
SERUM
time
VALUE
WHO
Issue Date: Oct-2007
Publisher: BMJ Publishing Group/British Cardiovascular Society
Citation: Grubb NR, Simpson C, Sherwood RA, Abraha HD, Cobbe SM, O'Carroll R, Deary I & Fox KAA (2007) Prediction of cognitive dysfunction after resuscitation from out- of-hospital cardiac arrest using serum neuron-specific enolase and protein S- 100, Heart, 93 (10), pp. 1268-1273.
Abstract: Background: More than 50% of patients initially resuscitated from out-of- hospital cardiac arrest die in hospital. Objective: To investigate the prognostic value of serum protein S-100 and neuron-specific enolase (NSE) concentrations for predicting (a) memory impairment at discharge; (b) in-hospital death, after resuscitation from out-of- hospital cardiac arrest. Methods: In a prospective study of 143 consecutive survivors of out-of-hospital cardiac arrest, serum samples were obtained within 12, 24-48 and 72-96 hours after the event. S-100 and NSE concentrations were measured. Pre-discharge cognitive assessment of patients (n = 49) was obtained by the Rivermead Behavioural Memory Test (RBMT). The relationship between biochemical brain marker concentrations and RBMT scores, and between marker concentrations and the risk of in-hospital death was examined. Results: A moderate negative relationship was found between S-100 concentration and memory test score, at all time points. The relationship between NSE and memory test scores was weaker. An S-100 concentration¬†greater than 0.29 ?g/l at time B predicted moderate to severe memory impairment with absolute specificity (42.8% sensitivity). S-100 remained an independent predictor of memory function after adjustment for clinical variables and cardiac arrest timing indices. NSE and S-100 concentrations were greater in patients who died than in those who survived, at all time points. Both NSE and S-100 remained predictors of in- hospital death after adjustment for clinical variables and cardiac arrest timing indices. The threshold concentrations yielding 100% specificity for in-hospital death were S-100: 1.20 ?g/l (sensitivity 44.8%); NSE 71.0 ?g/l (sensitivity 14.0%). Conclusions: Estimation of serum S-100 concentration after out-of-hospital cardiac arrest can be used to identify patients at risk of significant cognitive impairment at discharge. Serum S-100 and NSE concentrations measured 24-48 hours after cardiac arrest provide useful additional information.
Type: Journal Article
URI: http://hdl.handle.net/1893/9214
DOI Link: http://dx.doi.org/10.1136/hrt.2006.091314
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: Royal Infirmary of Edinburgh
University of Edinburgh
King's College Hospital
King's College Hospital
Glasgow Royal Infirmary
Psychology
University of Edinburgh
University of Edinburgh

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