title: The prognostic significance of the serum biomarker heart-fatty acidic binding protein in comparison with s100b in severe traumatic brain injury.
abstract: The outcome after severe traumatic brain injury (TBI) is largely unfavorable, with approximately two thirds of patients suffering from severe disabilities or dying during the first 6 months. Existing predictive models displayed only limited utility for outcome prediction in individual patients. Time courses of heart-fatty acidic binding protein (H-FABP) and their association with outcome were investigated and compared with S100b. Forty-nine consecutive patients with severe TBI (sTBI; Head component of the Abbreviated Injury Scale [HAIS] >3) with mono and multiple trauma were enrolled in this study. Enzyme-linked immunosorbent assay measured blood concentrations of H-FABP and S100b at 6, 12, 24, and 48 h after TBI. Outcome measures were conscious state at 14 days (Glasgow Coma Scale), disability (Glasgow Outcome Scale Extended; GOSE), and mortality at 3 months. Univariate logistic regression analysis and receiver operating characteristic curves analysis were carried out. Maximal H-FABP and S100b concentrations were observed at 6 h after TBI (34.4±34.0 and 0.64±0.99 ng/mL, respectively). Patients with multi-trauma had significantly higher H-FABP concentrations at 24 and 48 h (22.6±25.6 and 12.4±18.2 ng/mL, respectively), compared to patients with mono trauma (6.9±5.1 and 3.7±4.2 ng/mL, respectively). In the first 48 h, H-FABP and S100b were inversely correlated with the GOSE at 3 months; H-FABP at 48 h predicted mortality with 75% sensitivity and 93% specificity. Early blood levels of H-FABP after sTBI have prognostic significance for survival and disability.
authors.affiliation: 1 Division of Anaesthesiology, University Hospitals of Geneva , Geneva, Switzerland .
authors.forename: Bernhard
authors.initials: B
authors.lastname: Walder
authors.forename: Xavier
authors.initials: X
authors.lastname: Robin
authors.forename: Marie My Lien
authors.initials: MM
authors.lastname: Rebetez
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Copin
authors.forename: Yvan
authors.initials: Y
authors.lastname: Gasche
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Sanchez
authors.forename: Natacha
authors.initials: N
authors.lastname: Turck
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001930:Brain Injuries / Q000097:blood* / Q000473:pathology; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D016896:Treatment Outcome; D014474:Unconsciousness / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human