Serum S-100B protein monitoring in patients with severe traumatic brain injury.
OBJECTIVE
S-100B protein is a promising marker of injury severity and outcome after head injury. We examined the relationship between serum S-100B concentrations and injury severity, clinical course, survival, and treatment efficacy after severe traumatic brain injury (TBI).


METHODS
Prospective observational study in a neurosurgical intensive care unit.


METHODS
102 adult patients with severe TBI, admitted between June 2001 and November 2003 (30 months).


METHODS
Serum S-100B levels were measured by immunoluminometric technique on admission and every 24 h thereafter for a maximum of 7 days.


RESULTS
Initial S-100B levels were significantly related to pupillary status, computed tomography severity 1, and 1-month survival. Cox's proportional hazard regression analysis showed that initial S-100B was an independent predictor of 1-month survival, in the presence of dilated pupils, and with increased age. Subjects with initial levels above 1 microg/l had a nearly threefold increased probability of death within 1 month. Serum S-100B alteration indicated neurological improvement or deterioration. Finally, surgical treatment reduced S-100B levels.


CONCLUSIONS
Serum S-100B protein reflects injury severity and improves prediction of outcome after severe TBI. S-100B may also have a role in assessing the efficacy of treatment after severe TBI.
Korfias
Stefanos
S
Department of Neurosurgery, University of Newcastle upon Tyne, Newcastle General Hospital, Westgate Road, NE4 6BE, Newcastle upon Tyne, UK. Stefanos.Korfias@NUTH.NHS.UK
Stranjalis
George
G
Boviatsis
Efstathios
E
Psachoulia
Christina
C
Jullien
Gerard
G
Gregson
Barbara
B
Mendelow
A David
AD
Sakas
Damianos E
DE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001463:Barbiturates / Q000627:therapeutic use; D015415:Biomarkers; D001930:Brain Injuries / Q000097:blood* / Q000145:classification* / Q000628:therapy; D003399:Craniotomy; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D015601:Injury Severity Score; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*
D001463:Barbiturates; D015415:Biomarkers; D006993:Hypnotics and Sedatives; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins