Ability of S100B to predict severity and cranial CT results in children with TBI.
OBJECTIVE
To evaluate the ability of S100B to predict severity of TBI and abnormal cranial CT results for children with TBI.


METHODS
This is a secondary analysis of a previously established cohort of consecutive patients presenting to the emergency department with TBI limited to children <19 years of age, who arrived within 6 hours of injury, received a cranial CT scan and consented to blood drawn for S100B.


RESULTS
A total of 109 children were included in this cohort. The mean S100B levels were higher in children with moderate/severe TBI as compared to children with mild TBI based GCS score (0.281 µg L(-1), 95%CI = 0.101, 0.461 vs 0.053, 95%CI = 0.010, 0.095). S100B levels were significantly elevated in children following TBI with abnormal cranial CT as compared to children with a normal cranial CT (0.210 µg L(-1), SD = 0.313 vs 0.036 µg L(-1), SD = 0.046, p = 0.03). Area under the curve for S100B was also significant (0.72, 95%CI = 0.58, 0.86) for prediction of abnormal cranial CT for children with TBI. S100B did not predict abnormal cranial CT for children following TBI with a GCS of 15 (AUC = 0.53, 95%CI = 0.36, 0.71).


CONCLUSIONS
For children following TBI, S100B appears to predict severity of TBI; however, it may not be clinically useful as an independent screening test to select children with mild TBI who need a cranial CT.
Division of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. lynn.babcock@cchmc.org
Lynn
L
Babcock
Terri
T
Byczkowski
Sohug
S
Mookerjee
Jeffrey J
JJ
Bazarian
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D020201:Brain Hemorrhage, Traumatic / Q000097:blood* / Q000000981:diagnostic imaging; D001930:Brain Injuries / Q000097:blood* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000097:blood* / Q000000981:diagnostic imaging; D006408:Hematoma, Subdural / Q000097:blood* / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009414:Nerve Growth Factors / Q000097:blood*; D011237:Predictive Value of Tests; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D012680:Sensitivity and Specificity; 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