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

被引:51
作者
da Rocha, Adriana Brondani
Schneider, Rogerio Fett
de Freitas, Gabriel R.
Andre, Charles
Grivicich, Ivana
Zanoni, Caroline
Fossa, Aline
Gehrke, Junia T.
Jotz, Geraldo Pereira
Kaufmann, Mauro
Simon, Daniel
Regner, Andrea
机构
[1] Univ Luterana Brasil, Lab Marcadores Estresse Celular, Ctr Pesquisa Ciencias Med, BR-92425900 Canoas, RS, Brazil
[2] Univ Luterana Brasil, Programa Posgrad Diagnost Genet & Mol, BR-92425900 Canoas, RS, Brazil
[3] Univ Luterana Brasil, Programa Posgrad Genet & Toxicol Aplicada, BR-92425900 Canoas, RS, Brazil
[4] Univ Luterana Brasil, Curso Med, BR-92425900 Canoas, RS, Brazil
[5] Univ Fed Rio de Janeiro, Dept Neurol, Hosp Univ Clementino Fraga Filho, Rio De Janeiro, Brazil
[6] Univ Terapia Intens, Hosp Cristo Redentor, Porto Alegre, RS, Brazil
[7] SAMU, Hosp Municipal Pronto Socorro, Porto Alegre, RS, Brazil
关键词
biomarkers; humans; multitrauma; outcome; S100B protein; traumatic brain injury;
D O I
10.1515/CCLM.2006.218
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
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 - 8x (-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 mu g/ L) compared with the control group (0.037 mu g/L) and patients with fatal outcome had higher mean S100B (2.10 mg/ L) concentrations when compared with survivors (0.85 mg/ 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 mg/ 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.
引用
收藏
页码:1234 / 1242
页数:9
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