Association Between Procalcitonin Level at 72 Hours After Cardiac Arrest and Neurological Outcomes in Cardiac Arrest Survivors

Abstract

The association between procalcitonin (PCT) level measured 72 hours after cardiac arrest (CA) and neurological outcomes is unknown. We aimed to examine the association of serial PCT levels up to 72 hours with neurological outcomes in patients who underwent targeted temperature management (TTM) after CA. This retrospective observational study included adult comatose patients with CA undergoing TTM (33℃ for 24 hours) at the Chonnam National University Hospital in Gwangju, Korea, between January 2018 and December 2020. PCT levels were measured at admission and at 24, 48, and 72 hours after CA. The presence of early-onset infections (within 7 days after CA) was confirmed by reviewing clinical, radiological, and microbiological data. The primary outcome was poor neurological outcomes at 6 months and was defined by cerebral performance category 3–5. Among the CA survivors, 118 were included and 67 (56.8%) had poor neurological outcomes. The PCT level at 72 hours in the poor outcome group (3.01 [0.88–12.71]) was higher than that in good outcome group (0.56 [0.18–1.32]). The multivariate analysis revealed that the PCT level at 72 hours (adjusted odds ratio 1.241; 95% confidence interval, 1.059–1.455) was independently associated with poor neurological outcomes, showed good performance for poor outcomes (area under the receiver operating characteristic curve of 0.823), and was not associated with early-onset infections. The PCT level at 72 hours after CA can be helpful in predicting prognosis, and it did not correlate with early-onset infections in the study.