S-100beta protein-serum levels in healthy children and its association with outcome in pediatric traumatic brain injury.
OBJECTIVE
To describe normal serum levels of S-100beta in healthy children and determine whether serum S-100beta levels after traumatic brain injury are associated with outcome.


METHODS
Prospective cohort study.


METHODS
Urban, tertiary care, children's teaching hospital.


METHODS
A total of 136 healthy children and 27 children with traumatic brain injury.


METHODS
Serum S-100beta levels were measured in 136 healthy children. A total of 27 children with traumatic brain injury had S-100beta levels collected within 12 hrs of injury. Other indices of severity of injury measured were admission Glasgow Coma Scale score, and Pediatric Risk of Mortality score at 24 hrs (PRISM 24). Outcome was measured by the Pediatric Cerebral Performance Category (PCPC) score at hospital discharge and 6 months postinjury or at death.


RESULTS
S-100beta levels in healthy children had a mean of 0.3 microg/L (90% confidence interval, 0.03-1.47) and inversely correlated with age, (r = -.32, p <.001). In children with traumatic brain injury, 6-month postinjury outcome inversely correlated with Glasgow Coma Scale score (r = -.47, p =.01) and correlated with PRISM 24 score (r =.83, p <.001) and S-100beta levels (r =.75, p <.001). Six months postinjury, comparing good outcome (PCPC < or = 3, n = 20) vs. poor outcome (PCPC > or = 4, n = 7), median admission Glasgow Coma Scale scores were 8 (range, 3-15) and 3 (range, 3-7, p =.01), median PRISM 24 scores were 7 (range, 0-19) and 30 (range, 18-35, p <.001), and median S-100beta levels were 0.85 microg/L (range, 0.08-4.8 microg/L) and 3.6 microg/L (range, 1.4-20 microg/L, p <.001), respectively. A serum S-100beta level of > or =2.0 microg/L is associated with poor outcome, with a sensitivity of 86% and a specificity of 95%. The area under the receiver operating curve for S-100beta was 0.94 (+/-0.05).


CONCLUSIONS
Serum S-100beta levels in healthy children have a moderate inverse correlation with age. After traumatic brain injury in children, the acute assessment of serum S-100beta levels seems to be associated with outcome.
Spinella
Philip C
PC
Department of Anesthesiology, The Children's Hospital of Philadelphia, PA, USA.
Dominguez
Troy
T
Drott
Henry R
HR
Huh
Jimmy
J
McCormick
Lisa
L
Rajendra
Anil
A
Argon
Jesse
J
McIntosh
Tracy
T
Helfaer
Mark
M
D015415:Biomarkers / Q000097:blood*; D001835:Body Weight; D001930:Brain Injuries / Q000097:blood* / Q000401:mortality / Q000628:therapy; D016022:Case-Control Studies; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D010865:Pilot Projects; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins