Relationship of serum S100B levels and intracranial injury in children with closed head trauma.
OBJECTIVE
To determine if serum levels of S100B are higher in children with CHT and ICI as detected by cranial CT and if long bone fractures affect the level of S100B in children with CHT and skeletal injury.


METHODS
Children <18 years of age who presented to an urban pediatric emergency department or were transferred from a referral hospital within 6 hours after accidental closed head trauma and who underwent cranial computed tomography were enrolled prospectively. Mean serum S100B levels for children with or without intracranial injury (ICI) and long-bone fractures were evaluated through analysis of covariance.


RESULTS
One hundred fifty-two children, 24 with ICI and 128 without ICI, were enrolled prospectively. Twenty-five children had long-bone fractures. Children with ICI were significantly younger than those without ICI (6.9 vs 9.8 years; P = .01). The time of venipuncture after injury was significantly later in children with ICI (P = .03). Mean S100B levels were significantly greater for children with ICI (212.9 vs 84.4 ng/L; P = .001), children with long-bone fractures (P = .008), and nonwhite children (P = .03). After controlling for time of venipuncture, long-bone fractures, and race, mean S100B levels were still greater for children with ICI (409 vs 118 ng/L; P = .001). The ability of serum S100B measurements to detect ICI, determined as the area under the curve, was 0.67.


CONCLUSIONS
After controlling for time of venipuncture, long-bone fractures, and race, S100B levels were still higher in children with ICI than in those without ICI. However, the ability of serum S100B measurements to detect ICI was poor.
Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale University School of Medicine, 840 Howard Ave, First Floor, New Haven, CT 06504, USA. kirsten.bechtel@yale.edu
Kirsten
K
Bechtel
Sarah
S
Frasure
Clement
C
Marshall
James
J
Dziura
Christine
C
Simpson
D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D009414:Nerve Growth Factors / Q000097:blood*; D011237:Predictive Value of Tests; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D012737:Sex Factors; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human