title: Early and persistent high level of PS 100β is associated with increased poor neurological outcome in patients with SAH: is there a PS 100β threshold for SAH prognosis?
abstract: BACKGROUND
  Protein S100β (PS100 β) and neuron specific enolase (NSE) have been described as biological markers of neuronal damage. The purpose of our study was to assess the prognosis thresholds of these biomarkers in subarachnoid aneurysmal hemorrhage (SAH).
  
  
  METHODS
  Forty eight patients admitted following SAH were treated by endovascular coiling. Initial neurologic severity was assessed using the World Federation Neurologic Surgeons (WFNS), Fisher grades, initial Glasgow coma scale (GCS) and SAPS II. PS100β and NSE plasma concentration were measured daily within the first week. The primary endpoint of the study was the 6-month Glasgow Outcome Score (GOS) dichotomized as poor (GOS 1-3) or good (GOS 4-5).
  
  
  RESULTS
  A poor outcome at 6-months was associated with significant higher levels of S100β value from day 1 to day 7, whereas NSE values were significantly higher from day 5 to day 7. Best threshold value, for prognosis, was obtained at day 5 for PS100β >0.13 μg/L (specificity 0.95 95% confidence interval (CI) 0.74-1; sensitivity 0.83 95% CI 0.65-0.93) and day 7 for NSE >14.5 μg/L (specificity 0.90 95% CI 0.67-0.98); sensitivity (0.69 95% CI 0.51-0.83)). After multivariate logistic analysis, only PS100β at day 5 and SAPS II enabled to predict neurological outcome at 6 months (p<0.05).
  
  
  CONCLUSIONS
  PS100β >0.13 μg/L at day 5 is an independent predicting factor of poor neurological outcome at 6 months following SAH. This result could support the use of this biomarker at the acute phase of SAH to help physician determine the prognosis.
authors: Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. quintard.h@chu-nice.fr.
authors: Hervé
authors: H
authors: Quintard
authors: Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. leduc.s@chu-nice.fr.
authors: Sébastien
authors: S
authors: Leduc
authors: Department of Biochemistry, Hôpital Pasteur 1, Nice University Hospital, Nice, 06000, France. panaia-ferrari.p@chu-nice.fr.
authors: Patricia
authors: P
authors: Ferrari
authors: Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. petit.i@chu-nice.fr.
authors: Isabelle
authors: I
authors: Petit
authors: Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. ichai.c@chu-nice.fr.|IRCAN, UMR INSERM U10891-CNRS 7284, Faculté de Médecine, Nice Sophia-Antipolis University, Nice University Hospital, Nice, 06000, France. ichai.c@chu-nice.fr.
authors: Carole
authors: C
authors: Ichai
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood; D063868:Patient Outcome Assessment; D011379:Prognosis; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000401:mortality*
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit