SERUM TRANSACTIVE RESPONSE DNA BINDING PROTEIN 43 ASSOCIATES WITH POOR SHORT-TERM NEUROLOGIC OUTCOME AFTER RETURN OF SPONTANEOUS CIRCULATION FOLLOWING CARDIAC ARREST.

IF 2.7 3区 医学 Q2 CRITICAL CARE MEDICINE
SHOCK Pub Date : 2024-09-01 Epub Date: 2024-05-23 DOI:10.1097/SHK.0000000000002378
Zhangping Sun, Dongping Yu, Peijuan Li, Ling Wang, Yushu Chen, Xiaojun Wei, Ping Gong
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Abstract

Abstract: Objective : To explore the association of serum transactive response DNA binding protein 43 (TDP-43) with 28-day poor neurologic outcome in patients with return of spontaneous circulation (ROSC) after cardiac arrest. Methods : We performed a study between January and December 2023. Eligible patients with ROSC following cardiac arrest were enrolled. Their baseline characteristics were collected, and serum levels of TDP-43, tumor necrosis factor-α, interleukin-6 and 10, C-reactive protein, and neuron-specific enolase (NSE) at 24 h after ROSC were measured. The neurologic function was assessed by the cerebral performance category scores on day 28 after ROSC. Results : A total of 92 patients were included, with 51 and 41 patients in the good and poor neurologic outcome groups, respectively. Serum TDP-43 was significantly higher in the poor than the good neurologic outcome group ( P < 0.05). Univariate and multivariate logistic regression analyses showed that TDP-43, Witnessed CA, IL-6, and NSE were associated with poor 28-day neurologic outcome (all P < 0.05). Restricted cubic spline analysis revealed that TDP-43 at the serum level of 11.64 pg/mL might be an ideal cutoff value for distinguishing between good and poor neurologic outcomes. Area under curve of serum TDP-43 (AUC = 0.78) was close to that of serum NSE (AUC = 0.82). A dynamic nomogram prediction model that combined TDP-43, Witnessed CA, IL-6, and NSE was constructed and validated. Conclusion : Elevated serum TDP-43 level was associated with and could be used together with Witnessed CA, IL-6, and NSE to predict poor 28-day neurologic outcome in patients after ROSC following cardiac arrest.

血清转录反应 DNA 结合蛋白 43 与心脏骤停后恢复自主循环后的短期神经功能不良有关。
目的探讨心脏骤停后自发循环恢复(ROSC)患者血清转录反应DNA结合蛋白43(TDP-43)与28天不良神经功能预后的关系:我们在 2023 年 1 月至 12 月期间进行了一项研究。我们在 2023 年 1 月至 12 月期间进行了这项研究。收集了他们的基线特征,并测量了 ROSC 后 24 小时血清中 TDP-43、肿瘤坏死因子-α、白细胞介素-6 和-10、C 反应蛋白和神经元特异性烯醇化酶(NSE)的水平。ROSC后第28天,通过脑功能分类评分评估神经功能:结果:共纳入 92 例患者,其中神经功能预后良好组和不良组分别为 51 例和 41 例。神经功能预后不良组血清 TDP-43 明显高于神经功能预后良好组(P < 0.05)。单变量和多变量逻辑回归分析表明,TDP-43、Witnessed CA、IL-6 和 NSE 与 28 天神经功能预后差相关(均 P < 0.05)。限制性三次样条分析显示,血清中 TDP-43 水平为 11.64 pg/mL 可能是区分神经功能预后好坏的理想临界值。血清 TDP-43 的曲线下面积(AUC = 0.78)与血清 NSE 的曲线下面积(AUC = 0.82)接近。结合 TDP-43、Witnessed CA、IL-6 和 NSE,构建并验证了一个动态提名图预测模型:结论:血清 TDP-43 水平升高与 Witnessed CA、IL-6 和 NSE 相关,可用于预测心脏骤停后 ROSC 患者 28 天的不良神经功能预后。
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来源期刊
SHOCK
SHOCK 医学-外科
CiteScore
6.20
自引率
3.20%
发文量
199
审稿时长
1 months
期刊介绍: SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.
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