title: Reducing head computed tomography after mild traumatic brain injury: Screening value of clinical findings and S100B protein levels.
abstract: OBJECTIVE
  The present prospective study was performed to investigate whether primary clinical findings and serum S100B concentrations at 3 and 6 hours post-trauma can contribute to the selection of patients for an initial computed tomography (CT) scanning.
  
  
  METHODS
  S100B was measured in serum samples obtained at 3 and 6 hours after the injury. Adjusted odds ratios (OR) and 95% confidence interval (CI) associated with demographics and clinical predictors of positive CT scan were calculated. Sensitivity, specificity, negative and positive predictive values were also calculated for S100B levels.
  
  
  RESULTS
  It was found that the presence of loss of consciousness (OR = 2.3; 95% CI = 1.00-4.01; p = 0.008) and post-traumatic vomiting ≥ 2 episodes (OR = 1.8; 95% CI = 1.08-3.29; p = 0.019) are factors associated with positive CT scan. In this study the best cut-off point of 0.115 µg L(-1) for 3-hour S100B has sensitivity of 94.9% (95% CI = 86.8-98.3) with specificity of 35.4% (95% CI = 25.2-47.0) to predict intracranial injury on CT scanning. The corresponding results for 6-hour S100B > 0.210 µg L(-1) were 98.7% (95% CI = 92.1-99.9) for sensitivity and 39.2% (95% CI = 28.6-50.8) for specificity.
  
  
  CONCLUSIONS
  Serum S100B measurement along with clinical evaluation of patients with mild traumatic brain injury has promising screening value to support selection of patients for CT scanning.
authors.affiliation: a School of Medicine , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Shadi
authors.initials: S
authors.lastname: Asadollahi
authors.affiliation: b Department of Emergency Medicine , Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Heidari
authors.affiliation: b Department of Emergency Medicine , Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Taghizadeh
authors.affiliation: b Department of Emergency Medicine , Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Arash Mohammad
authors.initials: AM
authors.lastname: Seidabadi
authors.affiliation: c Department of Emergency Medicine , Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Jamshidian
authors.affiliation: b Department of Emergency Medicine , Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Vafaee
authors.affiliation: b Department of Emergency Medicine , Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Manoochehri
authors.affiliation: a School of Medicine , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Ali Habibzade
authors.initials: AH
authors.lastname: Shojaee
authors.affiliation: d Sina Trauma and Surgery Research Center , Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Hatamabadi
mesh_terms: D000328:Adult; D001924:Brain Concussion / Q000000981:diagnostic imaging*; D006259:Craniocerebral Trauma; D005260:Female; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood; D059906:Neuroimaging; D011446:Prospective Studies; D012372:ROC Curve; D064568:S100 Calcium Binding Protein beta Subunit / Q000032:analysis / Q000097:blood; D014057:Tomography, X-Ray Computed
chemical_list: D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human
keywords: Computed tomography; S100 protein; demographics; diagnosis; risk; traumatic brain injury