Citation

Thelin EP, Johannesson LK, Nelson DW, Bellander BM. J. Neurotrauma 2013; 30(7): 519-528.

Affiliation

Karolinska Institutet, Department of Clinical Neuroscience, Section for Neurosurgery, Stockholm, Sweden; thelin.eric@gmail.com.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2012.2553

PMID

23297751

Abstract

The objective for the study was to examine how S100B, a biomarker of traumatic brain injury (TBI), contributes to outcome prediction after adjusting for known parameters, including age, Glasgow Coma Scale (GCS), pupil reaction and computed tomography (CT) variables, to examine which parameters that have the best correlation to elevated serum levels of S100B and to investigate when to sample S100B to achieve the strongest association to outcome. This retrospective study included 265 patients suffering from TBI admitted to the Neurointensive care unit, Karolinska University Hospital Solna, Stockholm, Sweden. Univariate and multivariate proportional odds regressions were performed to determine parameters most closely related to outcome and how S100B adds to prediction accuracy. Age (p<0.0001), pupil reaction (p<0.0001) and levels of S100B (p<0.0001) had the strongest statistical correlation to outcome. The area under curve of S100B, the first 48 hours after trauma, yields an additional explained variance of 6.6% in excess of known outcome parameters, including age, GCS, pupil reaction and CT variables, themselves exhibiting an explained variance of 29.3%. S100B adds substantial information regarding patient outcome, in excess of that provided by known parameters. Only CT variables were found to be significant predictors to increased levels of S100B in uni- and multivariate analysis. Early samples of S100B, within 12 hours after trauma, appear to have little prognostic value and S100B should likely be sampled 12-36 hours following trauma to best enhance TBI outcome prediction.

Language: en