Head injury outcome prediction in the emergency department: a role for protein S-100B?
Head injury outcome prediction in the emergency department: a role for protein S-100B?
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DOI：
10.1136/jnnp.73.5.542
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发表时间：
2002-11-01
影响因子：
11
通讯作者：
Yates, DW
中科院分区：
文献类型：
--
作者：
Townend, WJ;Guy, MJ;Yates, DW
背景：头部受伤后释放的生化标志物可能反映脑损伤程度，与后续残疾有关。如果发现血清标志物水平与预后相关，则可以更早识别和干预。目的：探讨血清标志物S-100B蛋白预测颅脑损伤后预后的潜力。方法：从头部受伤后 6 小时内的 148 名成年人身上采集 S-100B 浓度的血液样本（初始格拉斯哥昏迷评分为 4-15）。患者是从英国大曼彻斯特的四家医院的急诊科招募的。使用扩展格拉斯哥结果量表 (GOSE) 在一个月内对 119 名患者 (80%) 的结果进行了评估。 结果：发现血清 S-100B 水平与 GOSE 之间存在显着负相关（Spearman's p = -0.349，p < 0.0001）。血清 S-100B 浓度 > 0.32 mug/l 预测一个月内的严重残疾 (GOSE < 5)，敏感性为 93%（95% 置信区间 68% 至 100%），特异性为 72%（54% 至 79%），阴性预测值为 99%（93% 至 100%）。结论：血清 S-100B 浓度可用于急诊科以确定最有可能在一个月内出现不良结果的头部受伤患者。
Background: Biochemical markers released after head injury may reflect the degree of brain damage, which is related to subsequent disability. If the serum level of a marker were found to be related to outcome, then earlier identification and intervention would be possible.Objective: To investigate the potential of the serum marker S-100B protein to predict the outcome after head injury. Methods: Blood samples for S-100B concentrations were taken from 148 adults within six hours of a head injury (initial Glasgow coma score 4-15). Patients were recruited from the emergency departments of four hospitals in Greater Manchester, United Kingdom. Outcome was assessed in 119 patients (80%) at one month using the extended Glasgow outcome scale (GOSE).Results: A significant inverse correlation between serum S-100B level and GOSE was found (Spearman's p = -0.349, p < 0.0001). A serum S-100B concentration of > 0.32 mug/l predicted severe disability (GOSE < 5) at one month with a sensitivity of 93% (95% confidence interval 68% to 100%), a specificity of 72% (54% to 79%), and a negative predictive value of 99% (93% to 100%).Conclusion: Serum S-100B concentration can be used in the emergency department to identify patients with head injury who are most likely to have a poor outcome at one month.