Serum S 100 B: A Marker of Brain Damage in Traumatic Brain Injury with and without Multiple Trauma

Abstract

This prospective clinical study was conducted to determine whether S 100 B is a reliable serum marker for traumatic brain injury (TBI) with and without multiple trauma. Fifty-five trauma patients (Injury Severity Score [ISS] > or = 24 and Glasgow Coma Score [GCS] < or = 8) were classified by radiography, computer tomography, ultrasound, and neurology as TBI without multiple trauma (n = 23), TBI with multiple trauma (n = 23), or multiple trauma without TBI (n = 9). S 100 B was measured initially after trauma and daily for a maximum of 21 days. Both survivors and nonsurvivors had markedly increased S 100 B initially. All survivors returned to normal or moderately increased S 100 B levels within the first 48 h after trauma. In contrast, all nonsurvivors of isolated TBI had S 100 B values that either increased consistently or dropped and then increased again 48 h after the initial increase after trauma. There was no relationship between localization, extent, or severity of TBI and S 100 B. According to receiver operating characteristic curve analysis and calculation of the area under the curve (AUC), S 100 B is equally accurate for mortality prediction at 24, 48, and 72 h after trauma and is most accurate >84 h after trauma. Sensitivity/specificity for mortality prediction are more accurate in TBI without multiple trauma (AUC 0.802-0.971) than in TBI with multiple trauma (AUC 0.693-0.783). Thus, though S 100 B may be a reliable marker of brain damage in TBI without multiple trauma 24 h after trauma and thereafter, it appears to be less reliable in TBI with multiple trauma.

Significance of Elecsys® S100 immunoassay for real-time assessment of traumatic brain damage in multiple trauma patients

“…The initial S100 levels in patients with TBI (CCTq) were even slightly lower than those without TBI (CCT-). These biochemical observations have already been reported by other authors, who mostly used the Sangtec ᮋ 100 immunoassay on a LIA-mat ᮋ S100 analyzer (35,36). Extracerebral sources of S100 release into the systemic circulation obviously seem to play an important role in multiple trauma patients.…”

“…Angemeldet | 129.187.254.47 Heruntergeladen am | 18.11.13 10:58 ceivable for the prediction of long-term prognosis, which would have to be proven in further studies with greater numbers of patients (35). Up to now, serial measurements of S100 serum levels using the Elecsys S100 ᮋ immunoassay have been recommended only for the follow-up and monitoring of therapy in patients with malignant melanoma (21).…”

Elevated Cell-Free Plasma DNA Level as an Independent Predictor of Mortality in Patients with Severe Traumatic Brain Injury

“…ICU scores are used to predict hospital outcome in critically ill patients, but have shortcomings. 5,6 Therefore, the wide range of conditions associated and the relatively variable predictive value of clinical assessments in severe TBI complicate the identification of patients at higher risk for development of secondary brain injury and fatal outcome. 7 Clearly, a practical and sensitive biomarker is needed to identify these patients, as early as possible, to initiate intervention and to indicate those persons to be targeted with higher risk therapeutic strategies.…”

Markers of Brain Damage in Severe Concomitant Injury

“…Было установлено, что он является специфическим биохимиче ским маркером при травматических повреждениях головного мозга [32][33][34][35], даже незначительных [36], играющим также важ ную роль в прогнозировании исхода. Кроме того, повышенный уровень сыворотки S 100β был также обнаружен при гипоксиче ском повреждении головного мозга после остановки сердца [37,38], при хирургических операциях на сердце во время [39] и по сле аорто коронарного шунтирования, при инсультах, при суб арахноидальном кровоизлиянии [40].…”