Serum S100B protein in early management of patients after mild traumatic brain injury

Morochovič, Radoslav; Rácz, Olivér; Kitka, M.; Pingorová, S.; Cibur, P.; Tomková, D; Lenártová, R.

doi:10.1111/j.1468-1331.2009.02653.x

Cited by 45 publications

(29 citation statements)

References 34 publications

(48 reference statements)

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“…In all of these series, serum levels of S100B failed to efficiently identify children with intracranial pathology on imaging studies. 1,3,8 These findings agree with those in the mild TBI study by Morochovic et al, 16 which showed that S100B is an unreliable screening tool for detecting intracranial pathology in adults and children. On the other hand, the study by Castellani et al 4 identified a role for S100B in the initial evaluation of children with mild TBI.…”

supporting

confidence: 82%

“…The sampling time of S100B in relation to the time of head injury is also an important factor that may influence its serum concentrations and thus make the interpretation of any S100B increases inconclusive in TBI cases. 8,16 Delayed serum measurements of S100B following a head injury may lead to erroneous conclusions regarding the severity and extent of neuronal damage, because of the relatively short half-life of the S100B protein. Geyer et al 8 emphasized the importance of the time span between injury and S100B blood sampling in the accurate measurement of S100B serum levels.…”

Section: Discussionmentioning

confidence: 99%

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Role of the S100B serum biomarker in the treatment of children suffering from mild traumatic brain injury

Filippidis¹,

Papadopoulos

Kapsalaki

et al. 2010

FOC

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Object The aim of this study was to provide a systematic update of the current literature regarding the clinical role of the S100B serum biomarker in the initial evaluation of children who have sustained a mild traumatic brain injury (TBI). Methods Searches in MEDLINE were defined with the keywords “mild TBI children S100,” “mild TBI pediatric S100,” and “children S100 brain injury.” From the pool of obtained studies, those that had the inclusion criteria of mild TBI only or mixed types of TBI but including detailed information about groups of children with mild TBI were used. Results Few studies were identified and fewer included more than 100 cases. The prospective studies showed that the S100B biomarker levels could be influenced by patient age and the time frame between head injury and blood sampling. Moreover, extracranial sources of S100B or additional injuries could influence the measured levels of this biomarker. A normal value of S100B in children with mild TBI could rule out injury-associated abnormalities on CT scans in the majority of reported cases. Conclusions The vulnerability of S100B serum levels to the influences of patient age, blood sampling time, and extracranial S100B release limits the biomarker's role in the initial evaluation of children with mild TBI. The application of S100B in pediatric mild TBI cases has an elusive role, although it could help in selected cases to avoid unnecessary head CT scans.

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supporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Role of the S100B serum biomarker in the treatment of children suffering from mild traumatic brain injury

Filippidis¹,

Papadopoulos

Kapsalaki

et al. 2010

FOC

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“…The design and patient characteristics of the 12 studies 98,113,115,130,[143][144][145][146][147][148][149][150] that evaluated the diagnostic accuracy of various biochemical markers for diagnosing ICI (including the need for neurosurgery) in adults and children with MHI are summarised in Table 18. Nine studies provided diagnostic data on protein S100B only, 98,113,115,[143][144][145][146][147][148][149] one on NSE only 115,130 and one on other markers [creatine kinase isozyme (CK-BB), noradrenaline, adrenaline, dopamine, amylase and total catecholamines].…”

Section: Description Of Included Studies (Design and Patient Charactementioning

confidence: 99%

Diagnostic management strategies for adults and children with minor head injury: a systematic review and an economic evaluation

Pandor

Goodacre²,

Harnan³

et al. 2011

Health Technol Assess

110

114

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTADiagnostic management strategies for adults and children with minor head injury: a systematic review and an economic evaluation NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA...

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“…Previous studies identified maximum sensitivity for abnormal head CT at an S100B level of 0.10-0.12 lg/L. 9,10,[25][26][27][28][29] In our cohort, the 98% sensitivity level was not reached until the S100B level was below 0.060 lg/L. At a cutoff of 0.10 lg/L, the FIG.…”

Section: Discussionmentioning

confidence: 66%

Classification Accuracy of Serum Apo A-I and S100B for the Diagnosis of Mild Traumatic Brain Injury and Prediction of Abnormal Initial Head Computed Tomography Scan

Bazarian

Blyth

et al. 2013

Journal of Neurotrauma

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The objective of the current study was to determine the classification accuracy of serum S100B and apolipoprotein (apoA-I) for mild traumatic brain injury (mTBI) and abnormal initial head computed tomography (CT) scan, and to identify ethnic, racial, age, and sex variation in classification accuracy. We performed a prospective, multi-centered study of 787 patients with mTBI who presented to the emergency department within 6 h of injury and 467 controls who presented to the outpatient laboratory for routine blood work. Serum was analyzed for S100B and apoA-I. The outcomes were disease status (mTBI or control) and initial head CT scan. At cutoff values defined by 90% of controls, the specificity for mTBI using S100B (0.899 [95% confidence interval (CI): 0.78-0.92]) was similar to that using apoA-I (0.902 [0.87-0.93]), and the sensitivity using S100B (0.252 [0.22-0.28]) was similar to that using apoA-I (0.249 [0.22-0.28]). The area under the receiver operating characteristic curve (AUC) for the combination of S100B and apoA-I (0.738, 95% CI: 0.71, 0.77), however, was significantly higher than the AUC for S100B alone (0.709, 95% CI: 0.68, 0.74, p = 0.001) and higher than the AUC for apoA-I alone (0.645, 95% CI: 0.61, 0.68, p < 0.0001). The AUC for prediction of abnormal initial head CT scan using S100B was 0.694 (95%CI: 0.62, 0.77) and not significant for apoA-I. At a S100B cutoff of < 0.060 lg/L, the sensitivity for abnormal head CT was 98%, and 22.9% of CT scans could have been avoided. There was significant age and race-related variation in the accuracy of S100B for the diagnosis of mTBI. The combined use of serum S100B and apoA-I maximizes classification accuracy for mTBI, but only S100B is needed to classify abnormal head CT scan. Because of significant subgroup variation in classification accuracy, age and race need to be considered when using S100B to classify subjects for mTBI.

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Serum S100B protein in early management of patients after mild traumatic brain injury

Abstract: S100B serum protein marker seems to be an unrealiable screening tool for determination of an intracranial injury risk group due to low sensitivity and negative predictive value seen from samples taken greater than 3 h after an MTBI.

Cited by 45 publications

References 34 publications

Role of the S100B serum biomarker in the treatment of children suffering from mild traumatic brain injury

Role of the S100B serum biomarker in the treatment of children suffering from mild traumatic brain injury

Diagnostic management strategies for adults and children with minor head injury: a systematic review and an economic evaluation

Classification Accuracy of Serum Apo A-I and S100B for the Diagnosis of Mild Traumatic Brain Injury and Prediction of Abnormal Initial Head Computed Tomography Scan

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