Correlation between brain injury biomarkers and Glasgow coma scale in pediatric sepsis

Background Sepsis in children, with or without multiple organ failure, causes increased susceptibility to brain injury due to systemic insults. Brain injury in sepsis is difficult to recognize clinically. Neuron-specific enolase (NSE) and S-lOOB have been extensively studied in brain injuries and appear to be promising alternative biomarkers. Objectives To determine if there is a correlation between the Glasgow coma scale (GCS) and NSE as well as S-lOOB levels, in children with sepsis. Methods We performed an analytical study on septic children aged > 2 years. GCS scores were assessed on the first and third days of admission. Blood specimens to test for NSE and S-lOOB were drawn on the first day of admission and stored at -70QC for further analysis at the end of the study. Results Out of 35 patients, 30 met the inclusion criteria. Postanalysis, one subject with NSE above the maximum level was excluded. Negative correlations were found between GCS score and NSE, as well as between GCS and S-lOOB levels. Analysis revealed a significant ROC for NSE, but not for S-lOOB. NSE concentration of 8.1 /.lg/L was the cut-off point for GCS scores below 12. Conclusions There were negative correlations between GCS and NSE levels, as well as between GCS and S- lOOB levels. The predictive value ofNSE level was a cut-off point of 8.1 /.lg/L for GCS scores below 12. [Paediatr lndones. 2012;52:111-17