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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Role of serum S100B as a predictive marker of fatal outcome following isolated severe head injury or multitrauma in males

Adriana Brondani da Rocha1 / Rogerio Fett Schneider2 / Gabriel R. de Freitas3 / Charles André4 / Ivana Grivicich5 / Caroline Zanoni6 / Aline Fossá7 / Junia T. Gehrke8 / Geraldo Pereira Jotz9 / Mauro Kaufmann10 / Daniel Simon11 / Andrea Regner12

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Corresponding author: Andrea Regner, Laboratório de Marcadores de Estresse Celular, Centro de Pesquisa em Ciências Médicas, ULBRA, Avenida Farroupilha, 8001, Prédio 22, 5 andar, CEP 92425-900, Bairro São José, Canoas, RS, Brazil Phone: +55-51-477-9219,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 44, Issue 10, Pages 1234–1242, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2006.218, October 2006

Publication History:
Received:
April 27, 2006
Accepted:
July 4, 2006
Published Online:
2006-10-10

Abstract

Background: Severe traumatic brain injury (TBI) is associated with a 30%–70% mortality rate. S100B has been proposed as a biomarker for indicating outcome after TBI. Nevertheless, controversy has arisen concerning the predictive value of S100B for severe TBI in the context of multitrauma. Therefore, our aim was to determine whether S100B serum levels correlate with primary outcome following isolated severe TBI or multitrauma in males.

Methods: Twenty-three consecutive male patients (age 18–65 years), victims of severe TBI [Glasgow Coma Scale (GCS) 3–8] (10 isolated TBI and 13 multitrauma with TBI) and a control group consisting of eight healthy volunteers were enrolled in this prospective study. Clinical outcome variables of severe TBI comprised: survival, time to intensive care unit (ICU) discharge, and neurological assessment [Glasgow Outcome Scale (GOS) at ICU discharge]. Venous blood samples were taken at admission in the ICU (study entry), 24 h later, and 7 days later. Serum S100B concentration was measured by an immunoluminometric assay.

Results: At study entry (mean time 10.9 h after injury), mean S100B concentrations were significantly increased in the patient with TBI (1.448 μg/L) compared with the control group (0.037 μg/L) and patients with fatal outcome had higher mean S100B (2.10μg/L) concentrations when compared with survivors (0.85 μg/L). In fact, there was a significant correlation between higher initial S100B concentrations and fatal outcome (Spearman's =0.485, p=0.019). However, there was no correlation between higher S100B concentrations and the presence of multitrauma. The specificity of S100B in predicting mortality according to the cut-off of 0.79 μg/L was 73% at study entry.

Conclusions: Increased serum S100B levels constitute a valid predictor of unfavourable outcome in severe TBI, regardless of the presence of associated multitrauma.

Clin Chem Lab Med 2006;44:1234–42.

Keywords: biomarkers; humans; multitrauma; outcome; S100B protein; traumatic brain injury

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