Abstract
Abstract Funding Acknowledgements Type of funding sources: None. Background Children suffering from cardiac arrest (CA) have high mortality due to neurological injury and prognostication tools are sparse. The biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) are known to predict outcome in adult CA, but the use in children is not well investigated. Purpose To assess the predictive value of the biomarkers NSE and S100b in children resuscitated from CA the first 72 hours following admission. Methods In-hospital and out-of-hospital CA patients, age <18 and comatose at intensive care unit admission, were included consecutively at our hospital from 2011-2021 and analyses of NSE and S100b levels were made at three timepoints following admission: 12 to 24 hours, 24 to 48 hours and 48 to 72 hours. Patients were divided into groups of "survivors" and "non-survivors". The primary endpoint was 30-day mortality. Biomarker levels in the two groups were compared using the Mann-Whitney U test. Predictive value of NSE and S100b was determined by applying receiver operating characteristics (ROC) curves with area under the curves (AUC) presented for each timepoint. Results We included 32 resuscitated patients with 12 (38%) patients dying within 30 days from resuscitation, i.e. 20 (62%) patients surviving. 14 patients were male sex and the median age was 15 years (6-16) in survivors. In non-survivors 8 patients were male sex and the median age was 7 years (2-15). Significantly higher levels of NSE and S100b were found in non-survivors compared to survivors at all timepoints following CA (Figure 1). For NSE the ROC curves obtained AUC values of 0.91 (0.75-1.0), 0.97 (0.92-1.0) and 0.98 (0.93-1.0) for prediction of 30-day mortality at the three timepoints. AUCs for S100b were 0.93 (0.84-1.0), 0.94 (0.86-1.0) and 0.94 (0.85-1.0), respectively. Conclusion Levels of NSE and S100b in children resuscitated from CA are associated with 30-day mortality and both biomarkers appear to be strong predictors of mortality.
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