title: S-100beta protein-serum levels in healthy children and its association with outcome in pediatric traumatic brain injury.
abstract: 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.
authors.affiliation: Department of Anesthesiology, The Children's Hospital of Philadelphia, PA, USA.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Spinella
authors.forename: Troy
authors.initials: T
authors.lastname: Dominguez
authors.forename: Henry R
authors.initials: HR
authors.lastname: Drott
authors.forename: Jimmy
authors.initials: J
authors.lastname: Huh
authors.forename: Lisa
authors.initials: L
authors.lastname: McCormick
authors.forename: Anil
authors.initials: A
authors.lastname: Rajendra
authors.forename: Jesse
authors.initials: J
authors.lastname: Argon
authors.forename: Tracy
authors.initials: T
authors.lastname: McIntosh
authors.forename: Mark
authors.initials: M
authors.lastname: Helfaer
mesh_terms: 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
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins