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S100 calcium binding protein B as a biomarker of delirium duration in the intensive care unit - an exploratory analysis.

ABSTRACT: Currently, there are no valid and reliable biomarkers to identify delirious patients predisposed to longer delirium duration. We investigated the hypothesis that elevated S100 calcium binding protein B (S100?) levels will be associated with longer delirium duration in critically ill patients.A prospective observational cohort study was performed in the medical, surgical, and progressive intensive care units (ICUs) of a tertiary care, university affiliated, and urban hospital. Sixty-three delirious patients were selected for the analysis, with two samples of S100? collected on days 1 and 8 of enrollment. The main outcome measure was delirium duration. Using the cutoff of <0.1 ng/mL and ?0.1 ng/mL as normal and abnormal levels of S100?, respectively, on day 1 and day 8, four exposure groups were created: Group A, normal S100? levels on day 1 and day 8; Group B, normal S100? level on day 1 and abnormal S100? level on day 8; Group C, abnormal S100? level on day 1 and normal on day 8; and Group D, abnormal S100? levels on both day 1 and day 8.Patients with abnormal levels of S100? showed a trend towards higher delirium duration (P=0.076); Group B (standard deviation) (7.0 [3.2] days), Group C (5.5 [6.3] days), and Group D (5.3 [6.0] days), compared to patients in Group A (3.5 [5.4] days).This preliminary investigation identified a potentially novel role for S100? as a biomarker for delirium duration in critically ill patients. This finding may have important implications for refining future delirium management strategies in ICU patients.

SUBMITTER: Khan BA

PROVIDER: S-EPMC3855164 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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S100 calcium binding protein B as a biomarker of delirium duration in the intensive care unit - an exploratory analysis.

Khan Babar A BA Farber Mark O MO Campbell Noll N Perkins Anthony A Prasad Nagendra K NK Hui Siu L SL Miller Douglas K DK Calvo-Ayala Enrique E Buckley John D JD Ionescu Ruxandra R Shekhar Anantha A Ely E Wesley EW Boustani Malaz A MA

International journal of general medicine 20131202

<h4>Background</h4>Currently, there are no valid and reliable biomarkers to identify delirious patients predisposed to longer delirium duration. We investigated the hypothesis that elevated S100 calcium binding protein B (S100β) levels will be associated with longer delirium duration in critically ill patients.<h4>Methods</h4>A prospective observational cohort study was performed in the medical, surgical, and progressive intensive care units (ICUs) of a tertiary care, university affiliated, and ...[more]

PMID: 24324346

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Project description:BackgroundAccurate prediction of delirium in the intensive care unit (ICU) may facilitate efficient use of early preventive strategies and stratification of ICU patients by delirium risk in clinical research, but the optimal delirium prediction model to use is unclear. We compared the predictive performance and user convenience of the prediction model for delirium (PRE-DELIRIC) and early prediction model for delirium (E-PRE-DELIRIC) in ICU patients and determined the value of a two-stage calculation.MethodsThis 7-country, 11-hospital, prospective cohort study evaluated consecutive adults admitted to the ICU who could be reliably assessed for delirium using the Confusion Assessment Method-ICU or the Intensive Care Delirium Screening Checklist. The predictive performance of the models was measured using the area under the receiver operating characteristic curve. Calibration was assessed graphically. A physician questionnaire evaluated user convenience. For the two-stage calculation we used E-PRE-DELIRIC immediately after ICU admission and updated the prediction using PRE-DELIRIC after 24 h.ResultsIn total 2178 patients were included. The area under the receiver operating characteristic curve was significantly greater for PRE-DELIRIC (0.74 (95% confidence interval 0.71-0.76)) compared to E-PRE-DELIRIC (0.68 (95% confidence interval 0.66-0.71)) (z score of - 2.73 (p < 0.01)). Both models were well-calibrated. The sensitivity improved when using the two-stage calculation in low-risk patients. Compared to PRE-DELIRIC, ICU physicians (n = 68) rated the E-PRE-DELIRIC model more feasible.ConclusionsWhile both ICU delirium prediction models have moderate-to-good performance, the PRE-DELIRIC model predicts delirium better. However, ICU physicians rated the user convenience of E-PRE-DELIRIC superior to PRE-DELIRIC. In low-risk patients the delirium prediction further improves after an update with the PRE-DELIRIC model after 24 h.Trial registrationClinicalTrials.gov, NCT02518646 . Registered on 21 July 2015.

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S100 calcium binding protein B as a biomarker of delirium duration in the intensive care unit - an exploratory analysis.

Publications

S100 calcium binding protein B as a biomarker of delirium duration in the intensive care unit - an exploratory analysis.

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