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J Neurotrauma. 2018 Feb 15;35(4):609-622. doi: 10.1089/neu.2017.5013. Epub 2018 Jan 22.

Prognostic Value of S-100β Protein for Prediction of Post-Concussion Symptoms after a Mild Traumatic Brain Injury: Systematic Review and Meta-Analysis.

Author information

1
1 Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine, Université Laval , Québec, Canada .
2
2 Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec, Université Laval , Québec, Canada .
3
3 Emergency and Trauma Centre, The Alfred Hospital , Alfred Health, Australia .
4
4 School of Public Health and Preventive Medicine, Monash University , Melbourne, Victoria, Australia .
5
5 National Trauma Research Institute , The Alfred Hospital, Melbourne, Victoria, Australia .
6
6 Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Vieillissement, Centre de recherche du CHU de Québec, Université Laval , Québec, Canada .
7
7 Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval , Québec, Canada .
8
8 Centre de Recherche et Centre Hospitalier Universitaire de Québec , Québec, Canada .
9
9 Research-Institute, McGill University Health Centre , Montreal, Québec, Canada .
10
10 Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Montréal , Québec, Canada .

Abstract

This systematic review and meta-analysis aimed to determine the prognostic value of S-100β protein to identify patients with post-concussion symptoms after a mild traumatic brain injury (mTBI). A search strategy was submitted to seven databases from their inception to October 2016. Individual patient data were requested. Cohort studies evaluating the association between S-100β protein level and post-concussion symptoms assessed at least seven days after the mTBI were considered. Outcomes were dichotomized as persistent (≥3 months) or early (≥7 days <3 months). Our search strategy yielded 23,298 citations of which 29 studies including between seven and 223 patients (n = 2505) were included. Post-concussion syndrome (PCS) (16 studies) and neuropsychological symptoms (9 studies) were the most frequently assessed outcomes. The odds of having persistent PCS (odds ratio [OR] 0.62, 95% confidence interval [CI]: 0.34-1.12, p = 0.11, I2 0% [n = five studies]) in patients with an elevated S-100β protein serum level were not significantly different from those of patients with normal values while the odds of having early PCS (OR 1.67, 95% CI: 0.98-2.85, p = 0.06, I2 38% [n = five studies]) were close to statistical significance. Similarly, having an elevated S-100β protein serum level was not associated with the odds of returning to work at six months (OR 2.31, 95% CI: 0.50-10.64, p = 0.28, I2 22% [n = two studies]). Overall risk of bias was considered moderate. Results suggest that the prognostic biomarker S-100β protein has a low clinical value to identify patients at risk of persistent post-concussion symptoms. Variability in injury to S-100ß protein sample time, mTBI populations, and outcomes assessed could potentially explain the lack of association and needs further evaluation.

KEYWORDS:

S-100ß protein; post-concussion symptoms; post-concussion syndrome; systematic review; traumatic brain injury

PMID:
28969486
DOI:
10.1089/neu.2017.5013

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