Management of Pediatric Mild Traumatic Brain Injury Patients: S100b, Glial Fibrillary Acidic Protein, and Heart Fatty-Acid-Binding Protein Promising Biomarkers.

Autor:	Chiollaz AC; Internal Medicine Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland., Pouillard V; Pediatric Neurology Unit, Woman, Child and Adolescent Department, Geneva University Hospitals, Geneva, Switzerland., Spigariol F; Pediatric Emergency Department, Neuchâtel Hospital (RHNE), Neuchatel, Switzerland., Romano F; Division of Pediatric Emergency Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland., Seiler M; Pediatric Emergency Department, University Children's Hospital Zurich, Zurich, Switzerland., Ritter Schenk C; Department of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland., Korff C; Pediatric Neurology Unit, Woman, Child and Adolescent Department, Geneva University Hospitals, Geneva, Switzerland., Habre C; Division of Radiology, University Hospitals of Geneva, Geneva, Switzerland., Maréchal F; Platform of Pediatric Clinical Research, Woman, Child and Adolescent Department, Geneva University Hospitals, Geneva, Switzerland., Wyss V; Division of Pediatric Emergency Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Switzerland., Gruaz L; Internal Medicine Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland., Lamana-Vallverdu M; Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Autonomous University of Barcelona, Barcelona, Spain., Chocano E; Neurovascular Research Laboratory, Vall d'Hebron Institute of Research, Autonomous University of Barcelona, Barcelona, Spain., Sempere Bordes L; Neurovascular Research Group, Institute of Biomedicine in Sevilla, Sevilla, Spain., Luaces-Cubells C; Pediatric Emergency Service, University Hospital San Joan de Deu, Esplugues del Llobregat, Barcelona, Spain., Méndez-Hernández M; Pediatric Service, University Hospital Germans Trias i Pujol, Barcelona, Spain., Alonso Cadenas JA; Pediatric Department, University Hospital Niño Jesús, Madrid, Spain., Carpio Linde MJ; Pediatric Emergency Service, University Hospital Virgen de la Macarena, Sevilla, Spain., de la Torre Sanchez P; Pediatric Emergency Service, University Hospital Virgen de la Macarena, Sevilla, Spain.
Jazyk:	angličtina
Zdroj:	Neurotrauma reports [Neurotrauma Rep] 2024 May 31; Vol. 5 (1), pp. 529-539. Date of Electronic Publication: 2024 May 31 (Print Publication: 2024).
DOI:	10.1089/neur.2024.0027
Abstrakt:	Children are highly vulnerable to mild traumatic brain injury (mTBI). Blood biomarkers can help in their management. This study evaluated the performances of biomarkers, in discriminating between children with mTBI who had intracranial injuries (ICIs) on computed tomography (CT+) and (1) patients without ICI (CT-) or (2) both CT- and in-hospital-observation without CT patients. The aim was to rule out the need of unnecessary CT scans and decrease the length of stay in observation in the emergency department (ED). Newborns to teenagers (≤16 years old) with mTBI (Glasgow Coma Scale > 13) were included. S100b, glial fibrillary acidic protein (GFAP), and heart fatty-acid-binding protein (HFABP) performances to identify patients without ICI were evaluated through receiver operating characteristic curves, where sensitivity was set at 100%. A total of 222 mTBI children sampled within 6 h since their trauma were reported. Nineteen percent ( n = 43/222) underwent CT scan examination, whereas the others ( n = 179/222) were kept in observation at the ED. Sixteen percent ( n = 7/43) of the children who underwent a CT scan had ICI, corresponding to 3% of all mTBI-included patients. When sensibility (SE) was set at 100% to exclude all patients with ICI, GFAP yielded 39% specificity (SP), HFABP 37%, and S100b 34% to rule out the need of CT scans. These biomarkers were even more performant: 52% SP for GFAP, 41% for HFABP, and 39% for S100b, when discriminating CT+ versus both in-hospital-observation and CT- patients. These markers can significantly help in the management of patients in the ED, avoiding unnecessary CT scans, and reducing length of stay for children and their families. (© Anne-Cécile Chiollaz et al., 2024; Published by Mary Ann Liebert, Inc.)
Databáze:	MEDLINE
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