Admission interleukin-6 is associated with post resuscitation organ dysfunction and predicts long-term neurological outcome after out-of-hospital ventricular fibrillation

作者：Vaahersalo Jukka^*; Skrifvars Markus B; Pulkki Kari; Strid**erg Mats; Rosjo Helge; Hovilehto Seppo; Tiainen Marjaana; Varpula Tero; Pettila Ville; Ruokonen Esko

来源：Resuscitation, 2014, 85(11): 1573-1579.

DOI：10.1016/j.resuscitation.2014.08.036

• Cardiac arrest
• Inflammation
• Interleukin-6
• High-sensitive C-reactive protein
• S-100B
• Long-term neurological outcome

Aim of the study: To study plasma concentrations of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and S-100B during intensive care after out-of-hospital cardiac arrest from ventricular fibrillation (OHCA-VF), and their associations with the duration of ischemia, organ dysfunction and long-term neurological outcome. %26lt;br%26gt;Materials and methods: A 12-month prospective observational multicentre study was conducted in 21 Finnish intensive care units in 2011. IL-6, hs-CRP and S-100B were measured at 0-6 h, 24 h, 48 h and 96 h after ICU admission. Associations with the time to return of spontaneous circulation (ROSC), sequential organ failure assessment (SOFA) scores divided into tertiles and 12-month cerebral performance category (CPC) were tested. %26lt;br%26gt;Results: Of 186 OHCA-VF patients included in the study, 110 (59.1%) patients survived with good neurological outcome (CPC 1-2) 12 months after cardiac arrest. Admission plasma concentrations of IL-6 but not hs-CRP were higher with prolonged time to ROSC (p %26lt; 0.001, 0.203, respectively), in patients with subsequent higher SOFA scores (p %26lt; 0.001, 0.069) and poor long-term neurological outcome (CPC 3-5) (p %26lt; 0.001, 0.315). S-100B concentrations over time were higher in patients with CPC of 3-5 (p %26lt; 0.001). The area under the curve for prediction of poor 12-month outcome for admission levels was 0.711 IL6, 0.663 for S-100B and 0.534 for hs-CRP. With multivariate logistic regression analysis only admission IL-6 (p = 0.046, OR 1.006, 95% CI 1.000-1.011/ng/L) was an independent predictor of poor neurological outcome. %26lt;br%26gt;Conclusion: Admission high IL-6, but not hs-CRP or S-100B, is associated with extra-cerebral organ dysfunction and along with age and time to ROSC are independent predictors for 12-month poor neurologic outcome (CPC 3-5).

• 出版日期2014-11