Comparison of the Predictability of Neurological Outcome by Serum Procalcitonin and Glial Fibrillary Acidic Protein in Postcardiac-Arrest Patients
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In past research, procalcitonin (PCT) and glial fibrillary acidic protein (GFAP) have been reported to be useful biomarkers in predicting neurological outcome after the return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (CA), although they have only been studied separately. In this study, we compared the usefulness of PCT and GFAP in predicting neurological outcome.
This study was a retrospective, single-center analysis, conducted in the intensive-care unit of a university hospital. Twenty-one sequential post-CA patients were included. Serum samples were collected from patients at 12 and 24 h after ROSC. Serum PCT and GFAP were measured and compared in patients with favorable and unfavorable neurological outcomes, evaluated at 6 months using the Glasgow–Pittsburgh Cerebral Performance Categories.
Serum PCT was significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.004 and 0.002, respectively). Serum GFAP was not significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.118 and 0.079, respectively). The combination of PCT and GFAP showed high predictive value for unfavorable outcomes (86.7% sensitivity and 100% specificity at 12 h; 100% sensitivity and 83.3% specificity at 24 h).
Serum PCT is a marker of unfavorable neurological outcome in post-CA patients, and is superior to serum GFAP in the early phase.
KeywordsNeurological outcome Cardiac arrest Brain damage Procalcitonin Glial fibrillary acidic protein
This clinical study was supported by a research project grant from the Japanese Ministry of Health, Labor, and Welfare (number 19791329). We are grateful to Hitomi Ikemoto for her valuable technical assistance in all measurements. We also express our thanks to Masako Ueda for assistance in completing the grant-related paperwork.
Conflict of Interest Statement
This study was conducted independently of the funding bodies, except for a governmental grant. This grant had no influence on the decisions relating to the study design or publication.
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