• Sebastian Wiberg, Jesper Kjaergaard, Benedict Kjærgaard, Bjarne Møller, Bo Nørnberg, Anne Marie Sørensen, Christian Hassager, and Michael Wanscher.
• Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark; Danish Armed Forces, Health Services, Aarhus, Denmark. Electronic address: sebastian.christoph.wiberg@regionh.dk.
• Resuscitation. 2017 Dec 1; 121: 49-53.

AimThe aim of the present study was to assess the ability of the biomarkers neuron-specific enolase (NSE) and S100 calcium-binding protein b (S100b) to predict mortality and poor neurologic outcome after 30days in patients admitted with severe accidental hypothermia.MethodsConsecutive patients with severe accidental hypothermia, defined as a core temperature <32°C, were included. Patients were treated with active rewarming and/or extracorporeal life support (ECLS) using extra corporeal circulation (ECC) and/or extra corporeal membrane oxygenation (ECMO). The day following admission blood was analyzed for NSE and S100b. Follow-up was conducted after 30days and poor neurologic outcome was defined as a Cerebral Performance Category (CPC) score of 3-5. The predictive value of NSE and S100b was assessed as the area under the receiver-operating characteristics curve (AUC).ResultsA total of 34 patients were admitted with a diagnosis of severe accidental hypothermia and 29 (85%) were resuscitated from cardiac arrest. ECLS was initiated in 27 (79%) of patients. The day following admission three (9%) patients had died and one (3%) patient was awake, and accordingly, NSE and S100b were analyzed in 30 unconscious and/or sedated patients. NSE and S100b achieved AUCs of 0.93 and 0.88, respectively, for prediction of 30day mortality and AUCs of 0.88 and 0.87, respectively, for prediction of poor neurologic outcome.ConclusionsIn patients remaining unconscious the day following admission for severe accidental hypothermia, the biomarkers NSE and S100b appear to be solid predictors of mortality and poor neurologic outcome after 30days.Copyright © 2017 Elsevier B.V. All rights reserved.

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