The Clinical Value of Serum S-100B Protein Measurements in Treating Minor Head Injury.
- Author:
Chan Woong KIM
1
;
Hye Ryoun KIM
;
Mi Kyung LEE
Author Information
1. Department of Emergency Medicine, Department of Laboratory Medicine1, YongSan Hospital, ChungAng University, Seoul, Korea. whenever@cau.ac.kr
- Publication Type:Original Article
- Keywords:
S-100 protein;
Computed tomography;
Minor head injury
- MeSH:
Craniocerebral Trauma*;
Diagnosis;
Head;
Healthy Volunteers;
Humans;
Multiple Trauma;
Prospective Studies;
ROC Curve;
S100 Calcium Binding Protein beta Subunit*;
S100 Proteins;
Sensitivity and Specificity
- From:Journal of the Korean Society of Emergency Medicine
2006;17(6):574-580
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Ninety percent of patients with minor head injury(MHI) who undergo computed tomography (CCT) under current clinical decision rules have normal scans. Serum concentrations of astroglial protein S-100B were recently found to provide useful information in such cases, but there is no clinical data in this country. We have investigated whether S-100B concentrations in alert patients with MHI can serve as an indicator of the need for an initial CCT scan. METHODS: 40 patients with MHI and a control group of 54 healthy volunteers were enrolled in this prospective study. All patients with MHI had a CCT scan to confirm diagnosis, and blood was drawn from all study participants in order to measure S-100B concentrations. Data were analyzed using contingency table and a receiver operating characteristic (ROC) curve to determine the diagnostic value of S-100B. RESULTS: Using a concentration cutoff of 0.12 microgram/L, patients with abnormal CCT findings were identified by S-100B measurement with a sensitivity level of 100% and a specificity level of 46%. S-100B concentrations for head injury patients with multiple trauma were increased more than for patients without combined injuries. CONCLUSION: Adding measurement of S-100B concentration to the clinical decision rules for a CCT scan in alert patients with MHI could allow a 46% reduction in scans in our study. However, before S-100B testing can be used clinically, larger domestic trials conforming to all appropriate ethical guidelines need to be conducted in the near future.
