Clinical significance of serum S100B levels in neurointensive care
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ORIGINAL ARTICLE
Clinical significance of serum S100B levels in neurointensive care Johan Unde´n Æ Ramona Astrand Æ Knut Waterloo Æ Tor Ingebrigtsen Æ Johan Bellner Æ Peter Reinstrup Æ Gunnar Andsberg Æ Bertil Romner
Published online: 25 April 2007 Humana Press Inc. 2007
Abstract Objective S100B is viewed as the most promising biomarker for brain damage. It has been proposed that this marker is useful in a Neurointensive Care Unit (NICU) as a monitoring parameter. This study aims to examine the clinical usefulness of daily serum S100B measurements in this setting.
This work was performed at the Neurointensive Care Unit at the department of Neurosurgery, Lund University Hospital, Lund, Sweden. J. Unde´n (&) Department of Anaesthesiology and Intensive Care, Halmstad Regional Hospital, Halmstad, Sweden e-mail: [email protected] R. Astrand J. Bellner B. Romner Department of Neurosurgery, Lund University Hospital, Lund, Sweden K. Waterloo T. Ingebrigtsen Departments of Neurosurgery/Neurology, Institute for Clinical Medicine, University of Tromso and University Hospital of North Norway, Tromso, Norway P. Reinstrup Department of Anaesthesiology and Intensive Care, Lund University Hospital, Lund, Sweden G. Andsberg Department of Neurology, Lund University Hospital, Lund, Sweden
Design Prospective consecutive inclusion of patients. Patients A total of 79 patients with confirmed or suspected head injury or cerebrovascular insults (CVIs) (based upon patient history, computed tomography (CT) and/or magnetic resonance imaging (MRI) and neurological examination including coma scoring) who required neurointensive care were included in the study. Interventions Sampling for S100B was performed at admission and daily until patients were discharged from the NICU. S100B measurements were statistically compared to occurrence of secondary complications and outcome according to Glasgow Outcome Scale (GOS), with focus on clinical prediction. Measurements and main results 17 of 79 patients (22%) had secondary neurological complications. Mean S100B levels were found to be an independent parameter associated with these complications (P = 0.03). Mean S100B levels were higher in patients with complications compared to those without on both the complication day (P = 0.033) and the day after (P = 0.015), but not the day prior to the complication (P = 0.62). S100B did not predict secondary neurological complication. Neither mean (P = 0.182) nor peak (P = 0.370) S100B levels were associated with or predicted outcome according to dichotomised GOS. Conclusion Daily S100B measurements are associated with secondary complications but not to outcome. However, daily S100B levels do not predict secondary complications, which limit the usefulness of this brain biomarker in this setting. Keywords S100B/S-100/S100 Neurocritical Neurointensive Monitoring Secondary complications Brain biomarker
Neurocrit Care (2007) 6:94–99
Introduction Biochemical markers are consistently being used as diagnostic tools for injuries to specific orga
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