S100B and brain natriuretic peptide predict functional neurological outcome after intracerebral haemorrhage.
OBJECTIVE
To determine the predictive value of S100b and brain natriuretic peptide (BNP) in order to determine accurately and quickly a discharge prognosis after primary supratentorial intracerebral haemorrhage (ICH).


METHODS
After IRB approval and informed consent, blood samples were obtained and analysed from 28 adult patients consecutively admitted to the neuroscience intensive care unit with computed tomography-proven supratentorial ICH from June 2003 and December 2004 within the first 24 h after symptom onset for S100b and BNP. Functional outcomes on discharge were dichotomized to favourable (mRS < 3) or unfavourable.


RESULTS
BNP (a neurohormone) and S100b (a marker of glial activation) were found to be independently highly predictive of functional neurological outcome at the time of discharge as measured by the modified Rankin Score (BNP: p < 0.01, r = 0.46; S100b: p < 0.01, r = 0.42) and the Barthel Index (BNP: p < 0.01, r = 0.54; s100b: p < 0.01, r = 0.50). Although inclusion of either biomarker produced additive value when included with traditional clinical prognostic variables, such as the ICH score (Barthel index: p < 0.01, r = 0.66; mRS: p < 0.01, r = 0.96), little predictive power is added with inclusion of both biomarkers in a regression model for neurological outcome.


CONCLUSIONS
Serum S100b and BNP levels in the first 24 h after injury accurately predict neurological function at discharge after supratentorial ICH.
James
Michael L
ML
Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. james040@mc.duke.edu
Blessing
Robert
R
Phillips-Bute
Barbara G
BG
Bennett
Ellen
E
Laskowitz
Daniel T
DT
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis*; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D009418:S100 Proteins / Q000097:blood*; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D009418:S100 Proteins; D020097:Natriuretic Peptide, Brain