The prognostic value of the temporal course of S100beta protein in post-acute severe brain injury: A prospective and observational study.
OBJECTIVE
To study the predictive capacity of early S100beta samples for long-term outcome prediction after severe TBI.


METHODS
Eighty-seven patients with severe TBI were studied. Clinical and CT scan were taken at admission. S100beta concentration was quantified at admission and 24, 48 and 72 hours post-TBI (days 0, 1, 2 and 3). Outcome was assessed 12 months after discharge using Glasgow Outcome Score (GOS).


RESULTS
Significant negative correlations were found between 1-year GOS and S100beta concentrations on days 1-3, but not on day 0. Deceased patients showed higher S100beta concentration than survivors on days 1-3. Good (GOS = 4-5) vs poor outcome (GOS = 1-3) differed significantly on day 3. Death outcome was independently predicted by day 2 (>2.37 microg l(-1)), day 3 (>1.41 microg l(-1)) samples and absence of pupillary reaction. Poor outcome was predicted independently only by pupillary reaction and the 72-hour sample (>1.1 microg l(-1)), but this predictive model was less satisfactory than the predictive model for death.


CONCLUSIONS
A temporal profile of S100beta release from admission to 72 hours post-TBI is strongly recommended for use in identifying patients at risk of developing a worse outcome. The S100beta protein might be an early biomarker for predicting long-term outcome in patients with acute severe TBI.
University Hospital Virgen del Rocío, Sevilla, Spain. murillomunoz@telefonica.net
Francisco
F
Murillo-Cabezas
Maria Angeles
MA
Muñoz-Sánchez
Maria Dolores
MD
Rincón-Ferrari
Juan Francisco
JF
Martín-Rodríguez
Rosario
R
Amaya-Villar
Susana
S
García-Gómez
José
J
León-Carrión
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001930:Brain Injuries / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000378:metabolism*; D017741:Survivors; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins