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Assessing bicycle-related trauma using the biomarker S100B reveals a correlation with total injury severity

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Worldwide, the use of bicycles, for both recreation and commuting, is increasing. S100B, a suggested protein biomarker for cerebral injury, has been shown to correlate to extracranial injury as well. Using serum levels of S100B, we aimed to investigate how S100B could be used when assessing injuries in patients suffering from bicycle trauma injury. As a secondary aim, we investigated how hospital length of stay and injury severity score (ISS) were correlated to S100B levels.

Methods

We performed a retrospective, database study including all patients admitted for bicycle trauma to a level 1 trauma center over a four-year period with admission samples of S100B (n = 127). Computerized tomography (CT) scans were reviewed and remaining data were collected from case records. Univariate- and multivariate regression analyses, linear regressions and comparative statistics (Mann–Whitney) were used where appropriate.

Results

Both intra- and extracranial injuries were correlated with S100B levels. Stockholm CT score presented the best correlation of an intracranial parameter with S100B levels (p < 0.0001), while the presences of extremity injury, thoracic injury, and non-cervical spinal injury were also significantly correlated (all p < 0.0001, respectively). A multivariate linear regression revealed that Stockholm CT score, non-cervical spinal injury, and abdominal injury all independently correlated with levels of S100B. Patients with a ISS > 15 had higher S100 levels than patients with ISS < 16 (p < 0.0001). Patients with extracranial, as well as intracranial- and extracranial injuries, had significantly higher levels of S100B than patients without injuries (p < 0.05 and p < 0.01, respectively). The admission serum levels of S100B (log, µg/L) were correlated with ISS (log) (r = 0.53) and length of stay (log, days) (r = 0.45).

Conclusions

S100B levels were independently correlated with intracranial pathology, but also with the extent of extracranial injury. Length of stay and ISS were both correlated with the admission levels of S100B in bicycle trauma, suggesting S100B to be a good marker of aggregated injury severity. Further studies are warranted to confirm our findings.

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Acknowledgments

This study was funded by the ‘Stiftelsen Tornspiran’. Authors of this manuscript, and not the funders, are responsible for its content. The funders had no role in the study design; the collection, analysis, and interpretation of the data; the writing of the manuscript; and the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Section for Neurosurgery, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital Solna, R2:02, 171 76, Stockholm, Sweden

    E. P. Thelin

  2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden

    E. Zibung, L. Riddez & C. Nordenvall

  3. Karolinska University Hospital Solna, 171 76, Stockholm, Sweden

    E. Zibung, L. Riddez & C. Nordenvall

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  1. E. P. Thelin
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  2. E. Zibung
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Correspondence to E. P. Thelin.

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Conflict of interest

Eric P Thelin has previously received lecturer fees from Roche Diagnostics when presenting the Scandinavian guidelines for minimal, mild and moderate head injuries. This has in no way influenced the text and material published in this manuscript. Evelyne Zibung, Louis Riddez and Caroline Nordenvall declare that they have no conflict of interest.

Compliance with ethical requirements

This was a retrospective, database study. All data have been unidentified and are presented on group level, thus it is impossible to identify individual patients. Ethical approval was given by the local ethics committee of Stockholm County, reference number 2010/1920-31/1.

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Thelin, E.P., Zibung, E., Riddez, L. et al. Assessing bicycle-related trauma using the biomarker S100B reveals a correlation with total injury severity. Eur J Trauma Emerg Surg 42, 617–625 (2016). https://doi.org/10.1007/s00068-015-0583-z

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  • DOI: https://doi.org/10.1007/s00068-015-0583-z

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