Neuroprotein s-100B -- a useful parameter in paediatric patients with mild traumatic brain injury?
OBJECTIVE
To examine the correlation of S-100B to cranial computerized tomography (CCT) scan results in children after mild traumatic brain injury (MTBI).


METHODS
One hundred and nine paediatric patients (0-18 years) with MTBI were included in this prospective single-centre study. Serum was collected within 6 h of trauma for determination of serum S-100B. The upper reference of S-100B was set to 0.16 mug/L. A CCT scan was performed in all patients and the results were correlated to the S-100B values.


RESULTS
Computerized tomography was abnormal in 36 patients showing intracerebral haemorrhages and/or skull fractures. Serum S-100B level was significantly higher in patients with a pathological condition as shown in CT scan results (p = 0.003). There were no false negative, but 42 false positive test results for S-100B. This resulted in a sensitivity of 1.00, specificity of 0.42, positive predictive value of 0.46 and negative predictive value of 1.00. An area under the receiver operating curve of 0.68 was calculated.


CONCLUSIONS
S-100B is a valuable tool to rule out patients with pathological CCT findings in a collective of paediatric patients with MTBI. Elevations of S-100B do not necessarily lead to a pathological finding in the CT scan, but values below the cut-off safely rule out the evidence of intracranial lesions.
Department of Pediatric Surgery, Medical University Graz, Graz, Austria. christoph.castellani@meduni-graz.at
C
C
Castellani
P
P
Bimbashi
E
E
Ruttenstock
P
P
Sacherer
T
T
Stojakovic
A-M
AM
Weinberg
D000293:Adolescent; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D009418:S100 Proteins / Q000097:blood*; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
D015415:Biomarkers; D009418:S100 Proteins