Procalcitonin serum levels after out-of-hospital cardiac arrest

Abstract

The time course of Procalcitonin (PCT) serum levels was assessed in cardiac arrest survivors and compared with S-100 serum levels concerning their predictive values for neurological outcome. PCT and S-100 serum levels were analyzed serially on admission and during the following 3 days after hospitalization in 23 patients successfully resuscitated from out-of-hospital cardiac arrest. At day 14 patients were divided into groups according to the Glasgow-Outcome-Scale (GOS): one group with bad neurological outcome (GOS 1-3) and one group with good neurological outcome (GOS 4-5). Group comparisons were performed with the Mann-Whitney U-Test. The diagnostic performance of PCT and S-100 levels was analyzed using receiver operating characteristics (ROC). Patients with a bad neurological outcome had significantly higher S-100 levels than those with a good neurological outcome at all investigated time points and significantly elevated PCT levels at days 1-3. Highest levels for S-100 were found immediately after hospitalization (3.4 +/- 3.8 vs. 0.7 +/- 0.3 microg/l, P=0.003), and for PCT at day 1 (37 +/- 103 vs. 0.2 +/- 0.2 microg/l, P=0.0002). The results show that PCT serum levels are possibly elevated in patients with bad neurological outcome after cardiac arrest, without signs of severe infection or concomitant sepsis. Based on this observation, studies on larger numbers of patients should prove the predictive value of PCT in those patients.