Premium
Elevated serum S‐100β in patients with septic shock is associated with delirium
Author(s) -
Erikson Kristo,
AlaKokko Tero Ilmari,
Koskenkari Juha,
Liisanantti Janne Henrik,
Kamakura Remi,
Herzig Karl Heinz,
Syrjälä Hannu
Publication year - 2019
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13228
Subject(s) - delirium , medicine , septic shock , odds ratio , gastroenterology , sepsis , sofa score , anesthesia , intensive care medicine
Background A high prevalence of delirium is observed in sepsis, yet specific markers for this brain dysfunction in sedated patients are still lacking. Cytoplasmic low molecular weight calcium‐binding protein, S‐100β, is a commonly used nonspecific marker for brain injury. Here, we evaluated whether delirium is associated with increases in S‐100β levels. Methods This observational study included 22 patients with septic shock. Delirium was assessed by CAM ‐ ICU and blood samples were obtained to measure inflammatory ( CRP , PCT , IL ‐6, IL ‐17, TNF ‐α) and cerebral biomarkers (S‐100β, NSE , HAB 42, SUBP ). Patients were categorized according to the presence of delirium. Results Delirium was present in 10/22 of the patients (45.5%). Serum S‐100β levels were above the laboratory cutoff value of 0.15 μg/L in 13/22 (59.1%) of the patients. The odds ratio for risk of developing delirium in cases with an S‐100β >0.15 μg/L was 18.0 (95% CI , 1.7‐196.3, P = 0.011). Patients with delirium had higher plasma levels of IL ‐6 compared to those without; 138.3 pg/ mL [28.0‐296.7] vs 53.6 pg/ mL [109.3‐505, P = 0.050]. There was a positive correlation between S100 β and IL ‐6 levels ( r = 0.489, P = 0.021). Delirium patients had higher SOFA scores; 10 [5‐9] vs 7[8‐10.5], P = 0.036. Conclusions Delirium in septic shock was associated with an elevated protein S‐100β when using a laboratory cutoff value of 0.15 μg/L and with more severe organ dysfunction during the ICU stay.