Importance of the S100B protein Assessment in Patients with Isolated Brain Injury

Czech version

Authors: P. Lavička ¹; R. Pikner ²; S. Kormunda ³; O. Topolčan ²; R. Bosman ⁴; I. Chytra ⁴; L. Holubec ²; M. Choc ¹
Authors‘ workplace: Neurochirurgické oddělení LF UK a FN, Plzeň ¹; Oddělení nukleární medicíny, úsek imunodiagnostiky, LF UK a FN, Plzeň ²; Ústav sociálního lékařství LF UK a FN, Plzeň ³; Anesteziologicko-resuscitační klinika LF UK a FN, Plzeň ⁴
Published in: Cesk Slov Neurol N 2007; 70/103(5): 521-526
Category: Original Paper

Tato práce byla podpořena grantem IGA MZ NR 7874-3/2004

Overview

Objective:
The objective of the study was to assess the importance of S100B protein in patients with CNS injury for clinical practice.

The method:
The study included 98 patients who were admitted to the Teaching Hospital of Pilsen from January 2004 to June 2006 due to isolated head injury. Generally used scoring protocols were used to evaluate the clinical status of the patients upon admittance and release, i.e. the Glasgow Coma Scale (CGS), APACHE II, Injury Severity Score (ISS) and Trauma Revised Injury Severity Score (TRISS) upon admittance, and the Glasgow Outcome Scale (GOS) upon release. The values of S100B protein were measured upon admittance and after 6, 12, 24 and 72 hours. The level of S100B protein was measured with the use of the Liaison immunoanalyser, DiaSorin, Italy.

Results:
We proved the relation between the absolute values of the S100B protein levels at all the times observed and the resulting clinical status for the patient sample we monitored. Best related to the resulting clinical status is the S100B protein value 24 hours after admittance (r = –0,540, p<0.0001). The value of 100B protein after at 24 hours over 1.17 μg/l means 12.8 times higher risk of negative resulting clinical status (p<0.0001) A drop in the level below 0.2 μg/l within 72 hours post-admittance is, on the contrary, associated with a 92% probability of a satisfactory clinical status.

Conclusion:
In practice, dynamic monitoring of S100B values of protein can be recommended, the most significant being the level 24 hours post-admittance, while the values below 0.2 μg/l predict a good resulting clinical status of the patient. With values over 0.2 μg/l, it is necessary to follow the level at 72 hours.

Key words:
S100B protein – isolated head injury – CT finding – Glasgow Coma Scale – ISS – TRISS – Glasgow Outcome Scale – resulting clinical status

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