From the Institute of Clinical Neuroscience, Department of Neurology
(H.R., L.R., C.B.) and Division of Cardiology (J.H.), Sahlgrens University
Hospital, University of Göteborg (Sweden).
Correspondence to Hans Rosén, MD, Sahlgrens University Hospital, University of Göteborg, S-413 45 Göteborg, Sweden. E-mail hans.rosen{at}neuro.gu.se
Background and Purpose Patients resuscitated from cardiac
arrest have a high early mortality rate. Prognostic evaluation based on
clinical observations is uncertain and would benefit from the use of
biochemical markers of hypoxic brain damage. The astroglial protein
S-100 is an established biochemical marker of central nervous system
injury. The purpose of the present study was to validate the use of
serum determinations of S-100 with regard to outcome after cardiac
arrest.
Methods Levels of serum S-100 were measured with a
radioimmunoassay in 41 patients the first 3 days after out-of-hospital
cardiac arrest. The main outcome variable was fatal outcome within
14 days.
Results S-100 levels were increased after cardiac arrest compared
with controls with the highest levels observed the first day. S-100
levels day 1 and 2 correlated to the degree of coma as well as to the
time of anoxia. Seventeen patients died within 14 days after the
cardiac arrest. The deceased patients had increased S-100 levels on
days 1 through 3 compared with survivors. All patients (100%) with an
S-100 level of
Conclusions The present study shows that hypoxic brain damage
after cardiac arrest can be estimated by measurement of serum S-100
concentrations. The method can be used in early prognostic evaluation
of short-term outcome after cardiac arrest.
© 1998 American Heart Association, Inc.
Original Contributions
Increased Serum Levels of the S-100 Protein Are Associated With Hypoxic Brain Damage After Cardiac Arrest
0.2 on day 2 after the cardiac arrest died within 14
days, and 89% of the patients with levels below this limit value
survived (positive and negative predictive values). The corresponding
predictive values on day 1 were 71% and 85%, respectively.
Key Words: cerebral ischemia, global • heart arrest • prognosis • proteins
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