Article Text

other Versions

PDF
S-100B and NSE are Poor Outcome Predictors in Severe Traumatic Brain Injury treated by an ICP Targeted Therapy
  1. Magnus Olivecrona (magnus.olivecrona{at}vll.se)
  1. Department of Pharmacology and Clinical Neurosciences, Div of Neurosurgery, Umeå Universtiy Hospital, Sweden
    1. Marie Rodling-Wahlström (marie.rodling.wahlstrom{at}vll.se)
    1. Dept of Surgical and Perioperative Sciences, Div of Anestestiolgy, Umeå University Hospital, Sweden
      1. Silvana Naredi (silvana.naredi{at}vll.se)
      1. Dept of Surgical and Perioperative Sciences, Div of Anestestiolgy, Umeå University Hospital, Sweden
        1. Lars-Owe D Koskinen (lars-owe.koskinen{at}neuro.umu.se)
        1. Department of Pharmacology and Clinical Neurosciences, Div of Neurosurgery, Umeå Universtiy Hospital, Sweden

          Abstract

          Objective: To prospectively study S-100B and NSE levels, in subjects treated for severe head injury (sTBI), and investigate the prognostic value of these biomarkers.

          Methods: Subjects included in a prospective double blinded randomised study for sTBI. Inclusion criteria; Glasgow Coma Score (GCS) ≤8, age 15 – 70 years, first recorded cerebral perfusion pressure of > 10 mmHg, and arrival < 24 hours after trauma. Subjects were treated with an intracranial pressure (ICP) targeted therapy. Blood samples for S-100B and NSE were drawn immediately after arrival and every 12 hour for five days. Outcome was evaluated as Glasgow Outcome Scale (GOS) by independent staff at 3 and 12 months.

          Results: 48 subjects, mean age 35.5 years, and median GCS 6 were included. The first blood sample was drawn at 15.6 ± 1.4 hours after injury. Initial concentration of S-100B was 1.04 ± 0.21 µg/l and for NSE 18.94 ± 2.32 µg/l. The biomarkers were significantly higher in subjects with those included as GCS 3 and in those who died as compared with GCS 4 – 8 and GOS 2 – 5, respectively. ROC curve analyses of the initial S-100B and NSE levels to GOS dichotomised as unfavourable (GOS 1-3) and favourable (GOS 4-5) showed a weak correlation; AUC 0.585 and 0.555 respectively. Using the dichotomisation dead (GOS 1) / alive (GOS 2-5), the AUC was 0.687 and 0.734 respectively. Further, a correlation was found between the biomarkers themselves and the biomarkers and ICP.

          Conclusion: We can at 3 and 12 months after trauma neither show any difference of prognostic values between the markers nor show any clinical significant value of the markers as predictors of clinical outcome.

          Statistics from Altmetric.com

          Request permissions

          If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.