Clinical validation of S100B in the management of a mild traumatic brain injury: issues from an interventional cohort of 1449 adult patients
| Autor: | Vincent Sapin, Damien Bouvier, Jeannot Schmidt, Daniel Pic, Jean Roubin, Farès Moustafa, Gautier Allouchery, Bruno Pereira, Julien Raconnat |
|---|---|
| Přispěvatelé: | Département des Urgences, CHU Clermont-Ferrand, Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Laboratoire de Biochimie, Génétique, Reproduction et Développement (GReD), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), service de Biostatistiques, DRCI, Centre Hospitalier Universitaire de Clermont-Ferrand, Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
genetic structures
[SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology Clinical Biochemistry S100B Cohort Studies 0302 clinical medicine Risk Factors MESH: Risk Factors Medicine Prospective Studies Prospective cohort study MESH: Cohort Studies MESH: Aged MESH: Middle Aged Age Factors Retrograde amnesia General Medicine Middle Aged 3. Good health [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry Molecular Biology/Biomolecules [q-bio.BM] MESH: Platelet Aggregation Inhibitors MESH: Young Adult Cohort Medium Risk Adult medicine.medical_specialty Adolescent Alcohol Drinking Traumatic brain injury S100 Calcium Binding Protein beta Subunit Sensitivity and Specificity 03 medical and health sciences Young Adult mTBI Internal medicine mild traumatic brain injury Humans In patient Aged MESH: Adolescent MESH: Age Factors MESH: Humans Adult patients business.industry MESH: S100 Calcium Binding Protein beta Subunit Biochemistry (medical) Significant difference 030208 emergency & critical care medicine MESH: Adult medicine.disease eye diseases MESH: Prospective Studies MESH: Sensitivity and Specificity Brain Injuries MESH: Brain Injuries MESH: Biomarkers sense organs business 030217 neurology & neurosurgery Biomarkers Platelet Aggregation Inhibitors MESH: Alcohol Drinking |
| Zdroj: | Clinical Chemistry and Laboratory Medicine Clinical Chemistry and Laboratory Medicine, De Gruyter, 2018, 56 (11), pp.1897-1904. ⟨10.1515/cclm-2018-0471⟩ Clinical Chemistry and Laboratory Medicine, 2018, 56 (11), pp.1897-1904. ⟨10.1515/cclm-2018-0471⟩ |
| ISSN: | 1434-6621 1437-4331 |
| Popis: | Background: This study’s primary objective was to validate the routine use of S100B via a prospective study. The aim was a reduction of cranial computed tomography (CCT) scans by 30%. The secondary goal was to investigate the influence of age and associated risk factors on the reduction of CCT. Methods: S100B (sampling within 3 h postinjury) was used for patients with mild traumatic brain injury (mTBIs) presenting a medium risk of complications and requiring a CCT scan. Patients with negative S100B (S100B−) were discharged without a CCT scan. Results: Of the 1449 patients included in this study, 468 (32.3%) had S100B− with a sensitivity of 96.4% (95% CI: 87.5%–99.6%), a specificity of 33.4% (95% CI: 31%–36%) and a negative predictive value of 99.6% (95% CI: 98.5%–99.9%). No significant difference in serum levels or the S100B+ rate was observed if patients had retrograde amnesia (0.16 μg/L; 63.8%), loss of consciousness (0.13; 63.6%) or antiplatelet therapy (0.20; 77.9%). Significant differences were found between the S100B concentrations and S100B positivity rates in patients >65 years old and all the groups with patients 65 years old (n=504). Conclusions: The clinical use of S100B in mTBI management reduces the use of CCTs by approximately one-third; furthermore, the percentage of CCTs reduction is influenced by the age of the patient. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|