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Brain Inj. 2016;30(2):172-8. doi: 10.3109/02699052.2015.1091504. Epub 2015 Dec 15.

Reducing head computed tomography after mild traumatic brain injury: Screening value of clinical findings and S100B protein levels.

Author information

1
a School of Medicine , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
2
b Department of Emergency Medicine , Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
3
c Department of Emergency Medicine , Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
4
d Sina Trauma and Surgery Research Center , Tehran University of Medical Sciences , Tehran , Iran.

Abstract

PRIMARY OBJECTIVE:

The present prospective study was performed to investigate whether primary clinical findings and serum S100B concentrations at 3 and 6 hours post-trauma can contribute to the selection of patients for an initial computed tomography (CT) scanning.

RESEARCH DESIGN AND METHODS:

S100B was measured in serum samples obtained at 3 and 6 hours after the injury. Adjusted odds ratios (OR) and 95% confidence interval (CI) associated with demographics and clinical predictors of positive CT scan were calculated. Sensitivity, specificity, negative and positive predictive values were also calculated for S100B levels.

MAIN OUTCOMES AND RESULTS:

It was found that the presence of loss of consciousness (OR = 2.3; 95% CI = 1.00-4.01; p = 0.008) and post-traumatic vomiting ≥ 2 episodes (OR = 1.8; 95% CI = 1.08-3.29; p = 0.019) are factors associated with positive CT scan. In this study the best cut-off point of 0.115 µg L(-1) for 3-hour S100B has sensitivity of 94.9% (95% CI = 86.8-98.3) with specificity of 35.4% (95% CI = 25.2-47.0) to predict intracranial injury on CT scanning. The corresponding results for 6-hour S100B > 0.210 µg L(-1) were 98.7% (95% CI = 92.1-99.9) for sensitivity and 39.2% (95% CI = 28.6-50.8) for specificity.

CONCLUSIONS:

Serum S100B measurement along with clinical evaluation of patients with mild traumatic brain injury has promising screening value to support selection of patients for CT scanning.

KEYWORDS:

Computed tomography; S100 protein; demographics; diagnosis; risk; traumatic brain injury

PMID:
26671496
DOI:
10.3109/02699052.2015.1091504
[Indexed for MEDLINE]

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