title: Clinical significance of serum S100B levels in neurointensive care.
abstract: OBJECTIVE
  S100B is viewed as the most promising biomarker for brain damage. It has been proposed that this marker is useful in a Neurointensive Care Unit (NICU) as a monitoring parameter. This study aims to examine the clinical usefulness of daily serum S100B measurements in this setting.
  
  
  METHODS
  Prospective consecutive inclusion of patients.
  
  
  METHODS
  A total of 79 patients with confirmed or suspected head injury or cerebrovascular insults (CVIs) (based upon patient history, computed tomography (CT) and/or magnetic resonance imaging (MRI) and neurological examination including coma scoring) who required neurointensive care were included in the study.
  
  
  METHODS
  Sampling for S100B was performed at admission and daily until patients were discharged from the NICU. S100B measurements were statistically compared to occurrence of secondary complications and outcome according to Glasgow Outcome Scale (GOS), with focus on clinical prediction.
  
  
  RESULTS
  17 of 79 patients (22%) had secondary neurological complications. Mean S100B levels were found to be an independent parameter associated with these complications (P=0.03). Mean S100B levels were higher in patients with complications compared to those without on both the complication day (P=0.033) and the day after (P=0.015), but not the day prior to the complication (P=0.62). S100B did not predict secondary neurological complication. Neither mean (P=0.182) nor peak (P=0.370) S100B levels were associated with or predicted outcome according to dichotomised GOS.
  
  
  CONCLUSIONS
  Daily S100B measurements are associated with secondary complications but not to outcome. However, daily S100B levels do not predict secondary complications, which limit the usefulness of this brain biomarker in this setting.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Halmstad Regional Hospital, Halmstad, and Neurointensive Care Unit, Department of Neurosurgery, Lund University Hospital, Sweden. johan.unden@med.lu.se
authors.forename: Johan
authors.initials: J
authors.lastname: Undén
authors.forename: Ramona
authors.initials: R
authors.lastname: Astrand
authors.forename: Knut
authors.initials: K
authors.lastname: Waterloo
authors.forename: Tor
authors.initials: T
authors.lastname: Ingebrigtsen
authors.forename: Johan
authors.initials: J
authors.lastname: Bellner
authors.forename: Peter
authors.initials: P
authors.lastname: Reinstrup
authors.forename: Gunnar
authors.initials: G
authors.lastname: Andsberg
authors.forename: Bertil
authors.initials: B
authors.lastname: Romner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000150:complications* / Q000628:therapy; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human