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. 2016 Mar 2;14(4):147-52.
doi: 10.5505/1304.7361.2014.74317. eCollection 2014 Dec.

Serum S100B Protein as an Outcome Prediction Tool in Emergency Department Patients with Traumatic Brain Injury

Mohsen Abbasi  1 , Mahmoudreza Sajjadi  1 , Marzieh Fathi  2 , Mohammadreza Maghsoudi  1
Affiliations

Serum S100B Protein as an Outcome Prediction Tool in Emergency Department Patients with Traumatic Brain Injury

Mohsen Abbasi et al. Turk J Emerg Med. .

Abstract
in English, Turkish

Objectives: Traumatic brain injury is a common cause of death and disability worldwide. Early recognition of patients with brain cellular damage allows for early rehabilitation and patient outcome improvement.

Methods: In this prospective study, the clinical conditions of patients with mild to moderate traumatic brain injury (TBI) were assessed, and patient serum S100B levels were measured. Patients were followed up one month later and evaluated for level of consciousness, presence or absence of post-traumatic headache, and daily activity performance (using the Barthel scale). Student's t-test and the chi-square test were used for data analysis, which was performed using SPSS software.

Results: The mean serum S100B value was significantly lower for patients with minor TBI than for patients with moderate TBI (23.1±14.2 ng/dl and 134.0±245.0 ng/dl, respectively). Patients with normal CT scans also had statistically significantly lower serum S100B levels than patients with abnormal CT findings. The mean S100B value was statistically significantly higher for patients with suspected diffused axonal injury (632.18±516.1 ng/dl) than for patients with other abnormal CT findings (p=0.000): 24.97±22.9 ng/dl in patients with normal CT results; 41.56±25.7 ng/dl in patients with skull bone fracture; 57.38 ±28.9 ng/dl in patients with intracranial hemorrhage; and 76.23±38.3 ng/dl in patients with fracture plus intracranial hemorrhage).

Conclusions: Serum S100B levels increase in patients with minor to moderate TBIs, especially in those with diffused axonal injury. However, serum S100B values cannot accurately predict one-month neuropsychological outcomes and performance.

Amaç: Travmatik beyin travması dünya ölçeğinde olağan bir ölüm ve özürlülük nedenidir. Beyin hücre hasarı olan hastaların erkenden tanınması erkendsen rehabilitasyon ve hasta sonuçlarında iyileşmeye olanak tanır.

Gereç ve yöntem: Bu prospektif çalışmada hafif-orta derecede travmatik beyin hasarı (TBH) olan hastaların klinik durumları değerlendirildi ve hastaların serum S100B düzeyleri ölçüldü. Hastalar bir ay sonra takip edildi, bilinç düzeyleri, travma sonrası baş ağrısı olup olmaması ve günlük aktivite performansı (Barthel ölçeğini kullanarak) açısından değerlendirildi. Veri analizinde SPSS yazılımı ile Student t-testi ve ki-kare testi kullanıldı.

Bulgular: Orta derecede TBH geçirmiş olanlara göre hafif derecede TBH geçirmiş hastalarda ortalama serum S100B değeri anlamlı derecede daha düşüktü (sırasıyla, 134,0±245,0 ng/dl ve 23,1±14,2 ng/dl). BT taramaları normal olmayan hastalara göre normal olanlarda serum S100B düzeyleri istatistiksel açıdan anlamlı derece daha düşüktü. Ortalama S100B değeri yaygın akson hasarından kuşkulanılan hastalarda (632,18±516,1 ng/dl) başka anormal BT bulguları olan hastalardan anlamlı derecede daha düşük idi (p=0.000). Normal BT sonuçları olan hastalarda, 24.97±22.9 ng/dl; kafatası kemiği kırıkları olanlarda 41.56±25.7 ng/dl; intrakraniyal kanaması olanlarda 57.38±28.9 ng/dl, kırıkla birlikte intrakraniyal kanaması olanlarda 76.23±38.3 ng/dl.

Sonuç: Hafif ve orta derecede TBH özellikle yaygın akson travması olanlarda serum S100B düzeyleri yükselmektedir. Ancak serum S100B değerleri 1 ay sonrasının nöropsikolojik sonuçları ve performansını doğru biçimde öngörememektedir.

Keywords: Biomarker; S100B protein; head trauma; traumatic brain injury.

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Figures

Figure 1
Figure 1
Participant flow over the course of the study.
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