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Clinical validation of S100B in the management of a mild traumatic brain injury: issues from an interventional cohort of 1449 adult patients

  • Gautier Allouchery , Farès Moustafa , Jean Roubin , Bruno Pereira , Jeannot Schmidt , Julien Raconnat , Daniel Pic , Vincent Sapin and Damien Bouvier EMAIL logo
Published/Copyright: June 20, 2018
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 56 Issue 11

Abstract

Background:

This study’s primary objective was to validate the routine use of S100B via a prospective study. The aim was a reduction of cranial computed tomography (CCT) scans by 30%. The secondary goal was to investigate the influence of age and associated risk factors on the reduction of CCT.

Methods:

S100B (sampling within 3 h postinjury) was used for patients with mild traumatic brain injury (mTBIs) presenting a medium risk of complications and requiring a CCT scan. Patients with negative S100B (S100B−) were discharged without a CCT scan.

Results:

Of the 1449 patients included in this study, 468 (32.3%) had S100B− with a sensitivity of 96.4% (95% CI: 87.5%–99.6%), a specificity of 33.4% (95% CI: 31%–36%) and a negative predictive value of 99.6% (95% CI: 98.5%–99.9%). No significant difference in serum levels or the S100B+ rate was observed if patients had retrograde amnesia (0.16 μg/L; 63.8%), loss of consciousness (0.13; 63.6%) or antiplatelet therapy (0.20; 77.9%). Significant differences were found between the S100B concentrations and S100B positivity rates in patients >65 years old and all the groups with patients <55 years old (18–25, 26–35, 36–45 and 46–55). From 18 to 65 years old (n=874), the specificity is 39.3% (95% CI: 36%–42.6%) compared to 18.7% (95% CI: 15.3%–22.3%) for patients >65 years old (n=504).

Conclusions:

The clinical use of S100B in mTBI management reduces the use of CCTs by approximately one-third; furthermore, the percentage of CCTs reduction is influenced by the age of the patient.

Keywords: mild traumatic brain injury; mTBI; S100B
Corresponding author: Dr. Damien Bouvier, Université Clermont Auvergne, CNRS, INSERM, GReD, Clermont-Ferrand, France, Phone: +33 4 73 75 48 82, Fax: +33 4 73 75 18 55
aGautier Allouchery and Farès Moustafa are considered co-first authors.

Acknowledgments

The authors would like to thank Scribendi for the academic editing of the manuscript.

  1. Author contributions: VS and DB conceived of the study, designed the trial and obtained ethical approval. GA and FM supervised the trial and data collection. FM, JRo, JS, JRa and DP recruited the patients. BP provided statistical advice for the study’s design and analyzed the data. GA drafted the manuscript, and all the authors substantially contributed to its revision. DB takes responsibility for the paper as a whole. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-01-31
Accepted: 2018-05-22
Published Online: 2018-06-20
Published in Print: 2018-10-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2018-0471
Keywords for this article
mild traumatic brain injury; mTBI; S100B

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. New biomarkers and traditional cardiovascular risk scores: any crystal ball for current effective advice and future exact prediction?
  4. Reviews
  5. Laboratory sample stability. Is it possible to define a consensus stability function? An example of five blood magnitudes
  6. Updated review of postmortem biochemical exploration of hypothermia with a presentation of standard strategy of sampling and analyses
  7. Long non-coding RNA-mediated regulation of signaling pathways in gastric cancer
  8. Opinion Paper
  9. Long story short: an introduction to the short-term and longterm Six Sigma quality and its importance in laboratory medicine for the management of extra-analytical processes
  10. EFLM Paper
  11. The European Federation of Clinical Chemistry and Laboratory Medicine syllabus for postgraduate education and training for Specialists in Laboratory Medicine: version 5 – 2018
  12. General Clinical Chemistry and Laboratory Medicine
  13. Early availability of laboratory results increases same day ward discharge rates
  14. Evaluation of the clinical implementation of a large-scale online e-learning program on venous blood specimen collection guideline practices
  15. Improved prospective risk analysis for clinical laboratories compensated for the throughput in processes
  16. National surveys on internal quality control for blood gas analysis and related electrolytes in clinical laboratories of China
  17. Clinical validation of S100B in the management of a mild traumatic brain injury: issues from an interventional cohort of 1449 adult patients
  18. A quantitative LC-MS/MS method for insulin-like growth factor 1 in human plasma
  19. Development and validation of a mass spectrometry-based assay for quantification of insulin-like factor 3 in human serum
  20. Anti-ganglioside antibodies: experience from the Italian Association of Neuroimmunology external quality assessment scheme
  21. Reference Values and Biological Variations
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  24. Cancer Diagnostics
  25. Exploring the potential of mucin 13 (MUC13) as a biomarker for carcinomas and other diseases
  26. Cardiovascular Diseases
  27. Prognostic implications of detectable cardiac troponin I below the 99th percentile in patients admitted to an emergency department without acute coronary syndrome
  28. Osteocalcin value to identify subclinical atherosclerosis over atherosclerotic cardiovascular disease (ASCVD) risk score in middle-aged and elderly Chinese asymptomatic men
  29. Infectious Diseases
  30. Comparison of four methods of establishing control limits for monitoring quality controls in infectious disease serology testing
  31. Letter to the Editor
  32. Letter to the Editor relative to Clin Chem Lab Med 2018;56(3):360–372
  33. Update in diagnosis and management of primary aldosteronism: reply to a Letter to the Editor
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