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Research Article

The prognostic value of the temporal course of S100β protein in post-acute severe brain injury: A prospective and observational study

, , , , , & show all
Pages 609-619 | Received 04 Aug 2009, Accepted 25 Jan 2010, Published online: 30 Mar 2010
 

Abstract

Primary objective: To study the predictive capacity of early S100β samples for long-term outcome prediction after severe TBI.

Methods and procedures: Eighty-seven patients with severe TBI were studied. Clinical and CT scan were taken at admission. S100β concentration was quantified at admission and 24, 48 and 72 hours post-TBI (days 0, 1, 2 and 3). Outcome was assessed 12 months after discharge using Glasgow Outcome Score (GOS).

Results: Significant negative correlations were found between 1-year GOS and S100β concentrations on days 1–3, but not on day 0. Deceased patients showed higher S100β concentration than survivors on days 1–3. Good (GOS = 4–5) vs poor outcome (GOS = 1–3) differed significantly on day 3. Death outcome was independently predicted by day 2 (>2.37 µg l−1), day 3 (>1.41 µg l−1) samples and absence of pupillary reaction. Poor outcome was predicted independently only by pupillary reaction and the 72-hour sample (>1.1 µg l−1), but this predictive model was less satisfactory than the predictive model for death.

Conclusions: A temporal profile of S100β release from admission to 72 hours post-TBI is strongly recommended for use in identifying patients at risk of developing a worse outcome. The S100β protein might be an early biomarker for predicting long-term outcome in patients with acute severe TBI.

Abbreviations
TBI=

traumatic brain injury

GOS=

Glasgow Outcome Score

CT=

computed tomography scan

ICU=

intensive care unit

CNS=

central nervous system

GCS=

Glasgow Coma Scale

AIS=

Abbreviated Injury Score

ISS=

Injury Severity Score

TCDB=

Traumatic Coma Data Bank

CPP=

cerebral perfusion pressure

OR=

odds ratio

ROC=

receiver operating characteristics

AUC=

area under the curve.

Abbreviations
TBI=

traumatic brain injury

GOS=

Glasgow Outcome Score

CT=

computed tomography scan

ICU=

intensive care unit

CNS=

central nervous system

GCS=

Glasgow Coma Scale

AIS=

Abbreviated Injury Score

ISS=

Injury Severity Score

TCDB=

Traumatic Coma Data Bank

CPP=

cerebral perfusion pressure

OR=

odds ratio

ROC=

receiver operating characteristics

AUC=

area under the curve.

Acknowledgements

This research was made possible in part by the generous donation of Protein S100β Electrochemiluminescence assay kits by Roche Diagnostics, Mannheim, Germany.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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