Abstract
Objective
S-100B protein is a promising marker of injury severity and outcome after head injury. We examined the relationship between serum S-100B concentrations and injury severity, clinical course, survival, and treatment efficacy after severe traumatic brain injury (TBI).
Design and setting
Prospective observational study in a neurosurgical intensive care unit.
Patients and participants
102 adult patients with severe TBI, admitted between June 2001 and November 2003 (30 months).
Interventions
Serum S-100B levels were measured by immunoluminometric technique on admission and every 24 h thereafter for a maximum of 7 days.
Measurements and results
Initial S-100B levels were significantly related to pupillary status, computed tomography severity1, and 1-month survival. Cox's proportional hazard regression analysis showed that initial S-100B was an independent predictor of 1-month survival, in the presence of dilated pupils, and with increased age. Subjects with initial levels above 1 μg/l had a nearly threefold increased probability of death within 1 month. Serum S-100B alteration indicated neurological improvement or deterioration. Finally, surgical treatment reduced S-100B levels.
Conclusions
Serum S-100B protein reflects injury severity and improves prediction of outcome after severe TBI. S-100B may also have a role in assessing the efficacy of treatment after severe TBI.
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Acknowledgements
We thank Mrs. Evi Delicha and Mrs. Barbara Gregson for their contribution in the statistical analysis of this study. We also thank Prof A. D. Mendelow, who kindly reviewed this manuscript and offered his suggestions. Finally, we also thank Mr. D. Chondros for his contribution in the analysis of brain CT scans, according to the Marshall classification.
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Korfias, S., Stranjalis, G., Boviatsis, E. et al. Serum S-100B protein monitoring in patients with severe traumatic brain injury. Intensive Care Med 33, 255–260 (2007). https://doi.org/10.1007/s00134-006-0463-4
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DOI: https://doi.org/10.1007/s00134-006-0463-4