S100B predicts neurological injury and 30-day mortality following surgery for acute type A aortic dissection : an observational cohort study
(2023) In Journal of Cardiothoracic Surgery 18(1).- Abstract
Background: Neurological injuries are frequent following Acute Type A Aortic Dissection (ATAAD) repair occurring in 4–30% of all patients. Our objective was to study whether S100B can predict neurological injury following ATAAD repair. Methods: This was a single-center, retrospective, observational study. The study included all patients that underwent ATAAD repair at our institution between Jan 1998 and Dec 2021 and had recorded S100B-values. The primary outcome measure was neurological injury, defined as focal neurological deficit or coma diagnosed by clinical assessment with or without radiological confirmation and with a symptom duration of more than 24 h. Secondary outcome measure was 30-day mortality. Results: 538 patients... (More)
Background: Neurological injuries are frequent following Acute Type A Aortic Dissection (ATAAD) repair occurring in 4–30% of all patients. Our objective was to study whether S100B can predict neurological injury following ATAAD repair. Methods: This was a single-center, retrospective, observational study. The study included all patients that underwent ATAAD repair at our institution between Jan 1998 and Dec 2021 and had recorded S100B-values. The primary outcome measure was neurological injury, defined as focal neurological deficit or coma diagnosed by clinical assessment with or without radiological confirmation and with a symptom duration of more than 24 h. Secondary outcome measure was 30-day mortality. Results: 538 patients underwent surgery during the study period and 393 patients, had recorded S100B-values. The patients had a mean age of 64.4 ± 11.1 years and 34% were female. Receiver operating characteristic curve for S100B 24 h postoperatively yielded area under the curve 0.687 (95% CI 0.615–0.759) and best Youden’s index corresponded to S100B 0.225 which gave a sensitivity of 60% and specificity of 75%. Multivariable logistic regression identified S100B ≥ 0.23 μg/l at 24 h as an independent predictor for neurological injury (OR 4.71, 95% CI 2.59–8.57; p < 0.01) along with preoperative cerebral malperfusion (OR 4.23, 95% CI 2.03–8.84; p < 0.01) as well as an independent predictor for 30-day mortality (OR 4.57, 95% CI 1.18–11.70; p < 0.01). Conclusions: We demonstrated that S100B, 24 h after surgery is a strong independent predictor for neurological injury and 30-day mortality after ATAAD repair. Trial registration: As this was a retrospective observational study it was not registered.
(Less)
- author
- Teurneau-Hermansson, Karl LU ; Ede, Jacob LU ; Larsson, Mårten LU ; Moseby-Knappe, Marion LU ; Bjursten, Henrik LU ; Nozohoor, Shahab LU ; Sjögren, Johan LU and Zindovic, Igor LU
- organization
-
- Thoracic Surgery
- Neurological injury in acute type A aortic dissection (research group)
- Minimal invasive cardiac surgery in valvular heart disease (research group)
- Bleeding disorders and acute typ-A dissection (research group)
- Neurology, Lund
- Brain Injury After Cardiac Arrest (research group)
- Less invasive cardiac surgery (research group)
- Heparin bindning protein in cardiothoracic surgery (research group)
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Aorta, Dissection, Neurological injury, S100B
- in
- Journal of Cardiothoracic Surgery
- volume
- 18
- issue
- 1
- article number
- 62
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:36747206
- scopus:85147460692
- ISSN
- 1749-8090
- DOI
- 10.1186/s13019-023-02151-2
- language
- English
- LU publication?
- yes
- additional info
- Funding Information: Open access funding provided by Lund University. This research has been funded by The Agreement for Medical Education and Research, Sweden and Region Skåne. Publisher Copyright: © 2023, The Author(s).
- id
- 61a9f017-9211-42ae-87a6-9a63cc02aefe
- date added to LUP
- 2023-02-20 08:05:56
- date last changed
- 2024-04-18 09:12:07
@article{61a9f017-9211-42ae-87a6-9a63cc02aefe, abstract = {{<p>Background: Neurological injuries are frequent following Acute Type A Aortic Dissection (ATAAD) repair occurring in 4–30% of all patients. Our objective was to study whether S100B can predict neurological injury following ATAAD repair. Methods: This was a single-center, retrospective, observational study. The study included all patients that underwent ATAAD repair at our institution between Jan 1998 and Dec 2021 and had recorded S100B-values. The primary outcome measure was neurological injury, defined as focal neurological deficit or coma diagnosed by clinical assessment with or without radiological confirmation and with a symptom duration of more than 24 h. Secondary outcome measure was 30-day mortality. Results: 538 patients underwent surgery during the study period and 393 patients, had recorded S100B-values. The patients had a mean age of 64.4 ± 11.1 years and 34% were female. Receiver operating characteristic curve for S100B 24 h postoperatively yielded area under the curve 0.687 (95% CI 0.615–0.759) and best Youden’s index corresponded to S100B 0.225 which gave a sensitivity of 60% and specificity of 75%. Multivariable logistic regression identified S100B ≥ 0.23 μg/l at 24 h as an independent predictor for neurological injury (OR 4.71, 95% CI 2.59–8.57; p < 0.01) along with preoperative cerebral malperfusion (OR 4.23, 95% CI 2.03–8.84; p < 0.01) as well as an independent predictor for 30-day mortality (OR 4.57, 95% CI 1.18–11.70; p < 0.01). Conclusions: We demonstrated that S100B, 24 h after surgery is a strong independent predictor for neurological injury and 30-day mortality after ATAAD repair. Trial registration: As this was a retrospective observational study it was not registered.</p>}}, author = {{Teurneau-Hermansson, Karl and Ede, Jacob and Larsson, Mårten and Moseby-Knappe, Marion and Bjursten, Henrik and Nozohoor, Shahab and Sjögren, Johan and Zindovic, Igor}}, issn = {{1749-8090}}, keywords = {{Aorta; Dissection; Neurological injury; S100B}}, language = {{eng}}, number = {{1}}, publisher = {{BioMed Central (BMC)}}, series = {{Journal of Cardiothoracic Surgery}}, title = {{S100B predicts neurological injury and 30-day mortality following surgery for acute type A aortic dissection : an observational cohort study}}, url = {{http://dx.doi.org/10.1186/s13019-023-02151-2}}, doi = {{10.1186/s13019-023-02151-2}}, volume = {{18}}, year = {{2023}}, }