• H Rosén, L Rosengren, J Herlitz, and C Blomstrand.
• Institute of Clinical Neuroscience, Department of Neurology, Sahlgrens University Hospital, University of Göteborg, Sweden. hans.rosen@neuro.gu.se
• Stroke. 1998 Feb 1;29(2):473-7.

Background And PurposePatients 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.MethodsLevels 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.ResultsS-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 > or =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.ConclusionsThe 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.

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