Role of serum S100B as a predictive marker of fatal outcome following isolated severe head injury or multitrauma in males.
BACKGROUND
Severe traumatic brain injury (TBI) is associated with a 30%-70% mortality rate. S100B has been proposed as a biomarker for indicating outcome after TBI. Nevertheless, controversy has arisen concerning the predictive value of S100B for severe TBI in the context of multitrauma. Therefore, our aim was to determine whether S100B serum levels correlate with primary outcome following isolated severe TBI or multitrauma in males.


METHODS
Twenty-three consecutive male patients (age 18-65 years), victims of severe TBI [Glasgow Coma Scale (GCS) 3-8] (10 isolated TBI and 13 multitrauma with TBI) and a control group consisting of eight healthy volunteers were enrolled in this prospective study. Clinical outcome variables of severe TBI comprised: survival, time to intensive care unit (ICU) discharge, and neurological assessment [Glasgow Outcome Scale (GOS) at ICU discharge]. Venous blood samples were taken at admission in the ICU (study entry), 24 h later, and 7 days later. Serum S100B concentration was measured by an immunoluminometric assay.


RESULTS
At study entry (mean time 10.9 h after injury), mean S100B concentrations were significantly increased in the patient with TBI (1.448 microg/L) compared with the control group (0.037 microg/L) and patients with fatal outcome had higher mean S100B (2.10 microg/L) concentrations when compared with survivors (0.85 microg/L). In fact, there was a significant correlation between higher initial S100B concentrations and fatal outcome (Spearman's =0.485, p=0.019). However, there was no correlation between higher S100B concentrations and the presence of multitrauma. The specificity of S100B in predicting mortality according to the cut-off of 0.79 microg/L was 73% at study entry.


CONCLUSIONS
Increased serum S100B levels constitute a valid predictor of unfavourable outcome in severe TBI, regardless of the presence of associated multitrauma.
da Rocha
Adriana Brondani
AB
Laboratório de Marcadores de Estresse Celular, Centro de Pesquisa em Ciências Médicas, Universidade Luterana do Brasil, Canoas, Brazil.
Schneider
Rogerio Fett
RF
de Freitas
Gabriel R
GR
André
Charles
C
Grivicich
Ivana
I
Zanoni
Caroline
C
Fossá
Aline
A
Gehrke
Junia T
JT
Pereira Jotz
Geraldo
G
Kaufmann
Mauro
M
Simon
Daniel
D
Regner
Andrea
A
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000401:mortality* / Q000503:physiopathology*; D001938:Brazil / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D016019:Survival Analysis
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human