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2017 | 64 | 4 | 647-652
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Serum levels of the S100B protein and neuron-specific enolase are associated with mortality in critically ill patients

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Introduction. Evaluation of the prognostic potential of the S100B protein and neuron-specific enolase (NSE) as predictors of mortality in critically ill patients in intensive care units (ICU). Materials and Methods. The study was conducted on 62 patients. Basic clinical variables and blood samples for S100B and NSE level testing were obtained during the first four days after admission. Mortality was described as the patient's death during hospitalization in the ICU. Results. 35% of the patients had died. The level of S100B and NSE was significantly higher in non-survivors in comparison with survivors (p=0.007 and p=0.02, respectively). Mortality risk was significantly higher in patients with higher levels of biomarkers than the reference values for S100B (OR 9.00; 95% CI 2.38-33.99; p<0.001) as well as for NSE (OR 5.75; 95%CI 1.31-25.27; p=0.016). Receiver operating characteristic proved that S100B is a better mortality predictor than NSE (AUC 0.76 for S100B and 0.68 for NSE). From all the other variables, the Apache II score turned out to be the only significant predictor of mortality (AUC 0.88). Conclusion. There is a significant correlation between mortality in the ICU and increased serum concentration of S100B and NSE. This correlation is stronger for S100B. Testing for serum levels of S100B and NSE may be useful for prediction of treatment outcomes in the ICU patients.
Physical description
  • Department of Anesthesiology and Intensive Care, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
  • Department of Anesthesiology and Intensive Care, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
  • Department of Physiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
  • Department of Physiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
  • Adamski J, Goraj R, Onichimowski D, Gawlikowska E, Weigl W (2015) The differences between two selected intensive care units located in central and northern Europe - preliminary observation. Anaesthesiol Intensive Ther 47: 117–124. doi: 10.5603/AIT.a2015.0010.
  • Anderson RE, Settergren G, Hansson LO (2001) High Serum S100B levels for trauma patients without head injuries. Neurosurgery 49: 1492-1493. doi: 10.1097/00006123-200112000-00056
  • Barone FC, Clark RK, Price WJ, White RF, Feuerstein GZ, Storer BL, Ohlstein EH (1993) Neuron-specific enolase increases in cerebral and systemic circulation following focal ischemia. Brain Res 623: 77-82.
  • Cruz D N, de Cal M, Garzotto F, Perazella MA, Lentini P, Corradi V, Ronco C (2010) Plasma neutrophil gelatinase-associated lipocalin is an early biomarker for acute kidney injury in an adult ICU population. Intensive Care Med 36: 444-4451. doi: 10.1007/s00134-009-1711-1.
  • Del Bufalo C, Morelli A, Bassein L, Fasano L, Quarta CC, Pacilli AM, Gunella G (1995) Severity scores in respiratory intensive care: APACHE II predicted mortality better than SAPS II. Respir Care 40: 1042-1047.
  • Diez M, Torres A, Ortega L, Maestro M, Hernando F, Gomez A, Picardo A, Granell J, Balibrea JL (1993) Value of serum neuron-specific enolase in nonsmall cell lung cancer. Oncology 50: 127-131.
  • Donato R, Cannon BR, Sorci G, Riuzzi F, Hsu K, Weber DJ, Geczy CL (2013) Functions of S100 proteins. Curr Mol Med 13: 24-57.
  • Ebersoldt M, Sharshar T, Annane D (2007) Sepsis-associated delirium. Intensive Care Med 33: 941-950. doi: 10.1007/s00134-007-0622-2.
  • Goyal A, Failla MD, Niyonkuru C, Amin K, Fabio A, Berger RP, Wagner AK (2013) S100b as a prognostic biomarker in outcome prediction for patients with severe traumatic brain injury. J Neurotrauma 30: 946-957. doi: 10.1089/neu.2012.2579.
  • Hamed SA, Hamed EA, Abdella MM (2009) Septic encephalopathy: relationship to serum and cerebrospinal fluid levels of adhesion molecules, lipid peroxides and S-100B protein. Neuropediatrics 40: 66-72. doi: 10.1055/s-0029-1231054.
  • Herrmann M, Curio N, Jost S, Wunderlich MT, Synowitz H, Wallesch CW (1999) Protein S-100B and neuron specific enolase as early neurobiochemical markers of the severity of traumatic brain injury. Restor Neurol Neurosci 14: 109-114.
  • Iacobone E, Bailly-Salin J, Polito A, Friedman D, Stevens RD, Sharshar T (2009) Sepsis-associated encephalopathy and its differential diagnosis. Crit Care Med 37: S331-S336. doi: 10.1097/CCM.0b013e3181b6ed58.
  • Jensen JU, Heslet L, Jensen T H, Espersen K, Steffensen P, Tvede M (2006) Procalcitonin increase in early identification of critically ill patients at high risk of mortality. Crit Care Med 34: 2596-2602. doi: 10.1097/01.CCM.0000239116.01855.61.
  • Karnak D, Beder S, Kayacan O, Ibiş E, Oflaz G (2005) Neuron-specific enolase and lung cancer. Am J Clin Oncol 28: 586-590.
  • Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE (1981) APACHE-acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med 9: 591-597.
  • Korfias S, Stranjalis G, Papadimitriou A, Psachoulia C, Daskalakis G, Antsaklis A, Sakas DE (2006) Serum S-100B protein as a biochemical marker of brain injury: a review of current concepts. Curr Med Chem 13: 3719-3731. doi: 10.2174/092986706779026129.
  • Korfias S, Stranjalis G, Boviatsis E, Psachoulia C, Jullien G, Gregson B, Mendelow AD, Sakas DE (2007) Serum S-100B protein monitoring in patients with severe traumatic brain injury. Intensive Care Med 33: 255-260.
  • Krzych ŁJ, Czempik PF, Saucha W, Kokocińska D, Knapik P (2015) Serum S100B protein concentration in brain-dead organ donors: a pilot study. Anaesthesiol Intensive Ther 47: 320-323. doi: 10.5603/AIT.2015.0041.
  • Macedo RC, Tomasi CD, Giombelli VR, Alves SC, Bristot ML, Locks MF, Ritter C (2013) Lack of association of S100β and neuron-specific enolase with mortality in critically ill patients. Rev Bras Psiquiatr 35: 267-270.
  • Marshall JC, Reinhart K (2009) Biomarkers of sepsis. Crit Care Med 37: 2290-2298. doi: 10.1097/CCM.0b013e3181a02afc.
  • Mercier E, Boutin A, Lauzier F, Fergusson DA, Simard JF, Zarychanski R, Légaré F (2013) Predictive value of S-100β protein for prognosis in patients with moderate and severe traumatic brain injury: systematic review and meta-analysis. BMJ 346: f1757. doi: 10.1136/bmj.f1757.
  • Michetti F, Corvino V, Geloso MC, Lattanzi W, Bernardini C, Serpero L, Gazzolo D (2012) The S100B protein in biological fluids: more than a lifelong biomarker of brain distress. J Neurochem 120: 644-659. doi: 10.1111/j.1471-4159.2011.07612.x.
  • Nguyen DN, Spapen H, Su F, Schiettecatte J, Shi L, Hachimi-Idrissi S, Huyghens L (2006) Elevated serum levels of S-100β protein and neuron-specific enolase are associated with brain injury in patients with severe sepsis and septic shock. Crit Care Med 34: 1967-1974. doi: 10.1097/01.CCM.0000217218.51381.49.
  • Nguyen HB, Loomba M, Yang JJ, Jacobsen G, Shah K, Otero RM, Rivers EP (2010) Early lactate clearance is associated with biomarkers of inflammation, coagulation, apoptosis, organ dysfunction and mortality in severe sepsis and septic shock. J Inflamm (Lond) 7: 6. doi: 10.1186/1476-9255-7-6.
  • Papadopoulos MC, Davies DC, Moss RF, Tighe D, Bennett ED. (2000) Pathophysiology of septic encephalopathy: a review. Crit Care Med 28: 3019-3024.
  • Pfortmueller CA, Drexel C, Krähenmann-Müller S, Leichtle AB, Fiedler GM, Lindner G, Exadaktylos AK (2016) S-100 B concentrations are a predictor of decreased survival in patients with major trauma, independently of head injury. PLoS One 11: e0152822. doi: 10.1371/journal.pone.0152822.
  • Rodríguez-Rodríguez A, Egea-Guerrero JJ, León-Justel A, Gordillo-Escobar E, Revuelto-Rey J, Vilches-Arenas Á, Guerrero J M (2012) Role of S100B protein in urine and serum as an early predictor of mortality after severe traumatic brain injury in adults. Clin Chim Acta 414: 228-233. doi: 10.1016/j.cca.2012.09.025.
  • Routsi C, Stamataki E, Nanas S, Psachoulia C, Stathopoulos A, Koroneos A, Roussos C (2006) Increased levels of serum S100B protein in critically ill patients without brain injury. Shock 26: 20-24. doi: 10.1097/01.shk.0000209546.06801.d7.
  • Satoh H, Ishikawa H, Kurishima K, Yamashita YT, Ohtsuka M, Sekizawa K (2002) Cut-off levels of NSE to differentiate SCLC from NSCLC. Oncol Rep 9: 581-583.
  • Siman R, Giovannone N, Toraskar N, Frangos S, Stein SC, Levine JM, Kumar MA (2011) Evidence that a panel of neurodegeneration biomarkers predicts vasospasm, infarction, and outcome in aneurysmal subarachnoid hemorrhage. PLoS One 6 : e28938. doi: 10.1371/journal.pone.0028938.
  • Stocchetti N (2005) Brain and sepsis: functional impairment, structural damage, and markers. Anesth Analg 101: 1463-1464. doi: 10.1213/01.ANE.0000181337.03655.0C.
  • Stranjalis G, Korfias S, Papapetrou C, Kouyialis A, Boviatsis E, Psachoulia C, Sakas DE (2004) Elevated serum S-100B protein as a predictor of failure to short-term return to work or activities after mild head injury. J Neurotrauma 21: 1070-1075. doi: 10.1089/0897715041651088.
  • Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter P M, Sprung C L, Colardyn F, Blecher S (1998) Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: Results of a multicenter, prospective study. Crit Care Med 26: 1793-1800.
  • Weigand MA, Volkmann M, Schmidt H, Martin E, Böhrer H, Bardenheuer HJ (2000) Neuron-specific enolase as a marker of fatal outcome in patients with severe sepsis or septic shock. Anesthesiology 92: 905-905.
  • Weigl W, Adamski J, Goryński P, Kański A, Hultström M (2017) Mortality rate is higher in Polish intensive care units than in other European countries. Intensive Care Med 43: 1430-1432. doi: 10.1007/s00134-017-4804-2.
  • Xu L, Lina W, Xuejun Y (2016) The diagnostic value of serum CEA, NSE and MMP-9 for on-small cell lung cancer. Open Med (Wars) 11: 59-62.
  • Yao B, Zhang LN, Ai YH (2014) Serum S100β is a better biomarker than neuron-specific enolase for sepsis-associated encephalopathy and determining its prognosis: a prospective and observational study. Neurochem Res 39: 1263-1269. doi: 10.1007/s11064-014-1308-0.
  • Zongo D, Ribéreau-Gayon R, Masson F, Laborey M, Contrand B, Salmi LR, Montaudon D, Beaudeux JL, Meurin A, Dousset V, Loiseau H, Lagarde E (2012) S100-B protein as a screening tool for the early assessment of minor head injury. Ann Emerg Med 59: 209-218. doi: 10.1016/j.annemergmed.2011.07.027.
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