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. 2015 Apr 7;10(4):e0122405.
doi: 10.1371/journal.pone.0122405. eCollection 2015.

Predictive value of S100-B and copeptin for outcomes following seizure: the BISTRO International Cohort Study

Yonathan Freund  1 , Benjamin Bloom  2 , Jerome Bokobza  3 , Nacera Baarir  4 , Said Laribi  5 , Tim Harris  2 , Vincent Navarro  6 , Maguy Bernard  7 , Rupert Pearse  8 , Bruno Riou  1 , Pierre Hausfater  1 ; BISTRO Investigators
Collaborators, Affiliations

Predictive value of S100-B and copeptin for outcomes following seizure: the BISTRO International Cohort Study

Yonathan Freund et al. PLoS One. .

Abstract

Objective: To evaluate the performance of S100-B protein and copeptin, in addition to clinical variables, in predicting outcomes of patients attending the emergency department (ED) following a seizure.

Methods: We prospectively included adult patients presented with an acute seizure, in four EDs in France and the United Kingdom. Participants were followed up for 28 days. The primary endpoint was a composite of seizure recurrence, all-cause mortality, hospitalization or rehospitalisation, or return visit in the ED within seven days.

Results: Among the 389 participants included in the analysis, 156 (40%) experienced the primary endpoint within seven days and 195 (54%) at 28 days. Mean levels of both S100-B (0.11 μg/l [95% CI 0.07-0.20] vs 0.09 μg/l [0.07-0.14]) and copeptin (23 pmol/l [9-104] vs 17 pmol/l [8-43]) were higher in participants meeting the primary endpoint. However, both biomarkers were poorly predictive of the primary outcome with a respective area under the receiving operator characteristic curve of 0.57 [0.51-0.64] and 0.59 [0.54-0.64]. Multivariable logistic regression analysis identified higher age (odds ratio [OR] 1.3 per decade [1.1-1.5]), provoked seizure (OR 4.93 [2.5-9.8]), complex partial seizure (OR 4.09 [1.8-9.1]) and first seizure (OR 1.83 [1.1-3.0]) as independent predictors of the primary outcome. A second regression analysis including the biomarkers showed no additional predictive benefit (S100-B OR 3.89 [0.80-18.9] copeptin OR 1 [1.00-1.00]).

Conclusion: The plasma biomarkers S100-B and copeptin did not improve prediction of poor outcome following seizure. Higher age, a first seizure, a provoked seizure and a partial complex seizure are independently associated with adverse outcomes.

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Conflict of interest statement

Competing Interests: Roche Diagnostics France (Meylan, France) provided free reagents and kits for S100B assays, and Thermo Fisher scientific B.R.A.H.M.S (Aktiengesellschaft, Hennigsdorf, Germany) provided free reagents and kits for copeptin assays. Roche diagnostics and Thermofisher scientific did not participate in the analysis of the data and did not see the manuscript before submission. ThermoFisher BRAHMS provided the copeptin assays free of charge, and funded our biochemistry technicians’ time of work in order to process all the analysis. Roche diagnostic provided the S100B assays free of charge. YF, BB, JB, NB, SL, TH, VN and MB had no other conflict of interest with this study. PH received lecture fees and clinical studies fees from Thermofisher scientific and honorarium from ROCHE diagnostic. BR received lecture fees from Thermofisher scientific This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow chart ED: emergency department.
Composite endpoint of recurrence, hospitalization or death at day seven.
Fig 2
Fig 2. S100B and copeptin values in the two groups.
Box plot with median, interquartile range, and 5th and 95th centile. Composite endpoint of recurrence, hospitalization or death at day seven.
Fig 3
Fig 3. Receiving operator characteristics curve for Copeptin and S100B.
Area under the curve 0.57 [95% CI 0.51–0.64] for S100B, p = 0.01, and 0.59 [95% CI 0.54–0.64] for copeptin, p = 0.02.
See this image and copyright information in PMC

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