Predictive value of soluble CD59 for poor 28-day neurological prognosis and all-cause mortality in patients after cardiopulmonary resuscitation: a prospective observatory study

Wang，Ling1,2; Li，Rui Fang3; Guan，Xiao Lan2; Liang，Shuang Shuang2; Gong，Ping4

2023-12-01

10.1186/s40560-023-00653-8

Journal of Intensive Care   Impact Factor & Quartile

2052-0492

2052-0492

Background: sCD59, as a soluble form of CD59, is observed in multiple types of body fluids and correlated with the cell damage after ischemia/reperfusion injury. This study aims to observe the dynamic changes of serum sCD59 in patients after restoration of spontaneous circulation (ROSC) and explore the association of serum sCD59 with neurological prognosis and all-cause mortality in patients after ROSC. Methods: A total of 68 patients after ROSC were prospectively recruited and divided into survivors (n = 23) and non-survivors (n = 45) groups on the basis of 28-day survival. Twenty healthy volunteers were enrolled as controls. Serum sCD59 and other serum complement components, including sC5b-9, C5a, C3a, C3b, C1q, MBL, Bb, and pro-inflammatory mediators tumor necrosis factor (TNF)-α, interleukin-6 (IL-6), neurological damage biomarkers neuron-specific enolase (NSE) and soluble protein 100β (S100β) were measured by enzyme linked immunosorbent assay on day 1, 3, and 7 after ROSC. Neurologic outcome was assessed using cerebral performance category scores, with poor neurologic outcome defined as 3–5 points. Results: In the first week after ROSC, serum levels of sCD59, sC5b-9, C5a, C3a, C3b, C1q, MBL, Bb, TNF-α, IL-6, NSE and S100β were significantly elevated in patients after ROSC compared to healthy volunteers, with a significant elevation in the non-survivors compared to survivors except serum C1q and MBL. Serum sCD59 levels were positively correlated with serum sC5b-9, TNF-α, IL-6, NSE, S100β, SOFA score and APACHE II score. Moreover, serum sCD59 on day 1, 3, and 7 after ROSC could be used for predicting poor 28-day neurological prognosis and all-cause mortality. Serum sCD59 on day 3 had highest AUCs for predicting poor 28-day neurological prognosis [0.862 (95% CI 0.678–0.960)] and 28-day all-cause mortality [0.891 (95% CI 0.769–0.962)]. In multivariate logistic regression analysis, the serum level of sCD59 was independently associated with poor 28-day neurological prognosis and all-cause mortality. Conclusions: The elevated serum level of sCD59 was positively correlated with disease severity after ROSC. Moreover, serum sCD59 could have good predictive values for the poor 28-day neurological prognosis and all-cause mortality in patients after ROSC.

Cardiopulmonary resuscitation Complement Ischemia–reperfusion injury Prognosis Soluble CD59

SCI

English

Corresponding

National Natural Science Foundation of China[81571869];

General & Internal Medicine

Critical Care Medicine

WOS:000922622100001

BMC

2-s2.0-85147277484

Scopus

1.Department of Neurology,The Affiliated Jinyang Hospital of Guizhou Medical University,Guiyang,Guizhou,China
2.Department of Emergency,First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning,China
3.Department of Emergency,General Hospital of Tianjin Medical University,Tianjin,China
4.Department of Emergency,Shenzhen People’s Hospital (The Second Clinical Medical College,Jinan University,The First Affiliated Hospital,Southern University of Science and Technology),Shenzhen,Guangdong Province,China

Wang，Ling,Li，Rui Fang,Guan，Xiao Lan,et al. Predictive value of soluble CD59 for poor 28-day neurological prognosis and all-cause mortality in patients after cardiopulmonary resuscitation: a prospective observatory study[J]. Journal of Intensive Care,2023,11(1).

Wang，Ling,Li，Rui Fang,Guan，Xiao Lan,Liang，Shuang Shuang,&Gong，Ping.(2023).Predictive value of soluble CD59 for poor 28-day neurological prognosis and all-cause mortality in patients after cardiopulmonary resuscitation: a prospective observatory study.Journal of Intensive Care,11(1).

Wang，Ling,et al."Predictive value of soluble CD59 for poor 28-day neurological prognosis and all-cause mortality in patients after cardiopulmonary resuscitation: a prospective observatory study".Journal of Intensive Care 11.1(2023).