title: S-100 B Concentrations Are a Predictor of Decreased Survival in Patients with Major Trauma, Independently of Head Injury.
abstract: BACKGROUND
  Major trauma remains one of the principle causes of disability and death throughout the world. There is currently no satisfactory risk assessment to predict mortality in patients with major trauma. The aim of our study is to examine whether S-100 B protein concentrations correlate with injury severity and survival in patients with major trauma, with special emphasis on patients without head injury.
  
  
  METHODS
  Our retrospective data analysis comprised adult patients admitted to our emergency department between 1.12. 2008 and 31.12 2010 with a suspected major trauma. S-100 B concentrations were routinely assessed in major trauma patients.
  
  
  RESULTS
  A total of 27.7% (378) of all patients had major trauma. The median ISS was 24.6 (SD 8.4); 16.6% (63/378) of the patients died. S-100 B concentrations correlated overall with the ISS (p<0.0001). Patients who died had significantly higher S-100 B concentrations than survivors (8.2 μg/l versus 2.2 μg/l, p<0.0001). Polytraumatised patients with and without head trauma did not differ significantly with respect to S-100 B concentration (3.2 μg/l (SD 5.3) versus 2.9 μg/l (SD 3.8), respectively, p = 0.63) or with respect to Injury Severity Score (24.8 (SD 8.6) versus 24.2 (SD 8.1), respectively, p = 0.56). S-100 B concentrations correlated negatively with survival (p<0.0001) in all patients and in both subgroups (p = 0.001 and p = 0.006, respectively).
  
  
  CONCLUSIONS
  S-100 concentrations on admission correlate positively with greater injury severity and decreased survival in major trauma patients, independently of the presence of a head injury. S-100 B protein levels at admission in patients with major trauma may therefore be used to assess outcome in all polytraumatised patients. These measurements should be subject to further evaluation.
authors.affiliation: Clinic for General Anaesthesiology, Intensive Care and Pain Management, Vienna General Hospital and University of Vienna, Vienna, Austria.|Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Carmen Andrea
authors.initials: CA
authors.lastname: Pfortmueller
authors.affiliation: Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Drexel
authors.affiliation: Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Simone
authors.initials: S
authors.lastname: Krähenmann-Müller
authors.affiliation: Centre of Laboratory Medicine, University Institute of Clinical Chemistry, Inselspital-Bern University Hospital, Inselspital, Bern, Switzerland.
authors.forename: Alexander Benedikt
authors.initials: AB
authors.lastname: Leichtle
authors.affiliation: Centre of Laboratory Medicine, University Institute of Clinical Chemistry, Inselspital-Bern University Hospital, Inselspital, Bern, Switzerland.
authors.forename: Georg Martin
authors.initials: GM
authors.lastname: Fiedler
authors.affiliation: Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.|Department of Emergency Medicine, Hirslandenklinik am Park Zurich, Zurich, Switzerland.
authors.forename: Gregor
authors.initials: G
authors.lastname: Lindner
authors.affiliation: Department of Emergency Medicine, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Aristomenis Konstantinos
authors.initials: AK
authors.lastname: Exadaktylos
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood / Q000401:mortality; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D064568:S100 Calcium Binding Protein beta Subunit