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Serum S-100B protein monitoring in patients with severe traumatic brain injury

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Abstract

Objective

S-100B protein is a promising marker of injury severity and outcome after head injury. We examined the relationship between serum S-100B concentrations and injury severity, clinical course, survival, and treatment efficacy after severe traumatic brain injury (TBI).

Design and setting

Prospective observational study in a neurosurgical intensive care unit.

Patients and participants

102 adult patients with severe TBI, admitted between June 2001 and November 2003 (30 months).

Interventions

Serum S-100B levels were measured by immunoluminometric technique on admission and every 24 h thereafter for a maximum of 7 days.

Measurements and results

Initial S-100B levels were significantly related to pupillary status, computed tomography severity1, and 1-month survival. Cox's proportional hazard regression analysis showed that initial S-100B was an independent predictor of 1-month survival, in the presence of dilated pupils, and with increased age. Subjects with initial levels above 1 μg/l had a nearly threefold increased probability of death within 1 month. Serum S-100B alteration indicated neurological improvement or deterioration. Finally, surgical treatment reduced S-100B levels.

Conclusions

Serum S-100B protein reflects injury severity and improves prediction of outcome after severe TBI. S-100B may also have a role in assessing the efficacy of treatment after severe TBI.

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Acknowledgements

We thank Mrs. Evi Delicha and Mrs. Barbara Gregson for their contribution in the statistical analysis of this study. We also thank Prof A. D. Mendelow, who kindly reviewed this manuscript and offered his suggestions. Finally, we also thank Mr. D. Chondros for his contribution in the analysis of brain CT scans, according to the Marshall classification.

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Correspondence to Stefanos Korfias.

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Korfias, S., Stranjalis, G., Boviatsis, E. et al. Serum S-100B protein monitoring in patients with severe traumatic brain injury. Intensive Care Med 33, 255–260 (2007). https://doi.org/10.1007/s00134-006-0463-4

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  • DOI: https://doi.org/10.1007/s00134-006-0463-4

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