Relation between Serum S100beta and Severity and Prognosis in Traumatic Brain Injury

Kim,  Oh Hyun; Lee,  Kang Hyun; Yoon,  Kap Jun; Park,  Kyung Hye; Jang,  Yong Su; Kim,  Hyun; Hwang,  Sung Oh

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Original Article

Journal of the Korean Society of Traumatology 2007;20(2):138-143.

Relation between Serum S100beta and Severity and Prognosis in Traumatic Brain Injury

Oh Hyun Kim, Kang Hyun Lee, Kap Jun Yoon, Kyung Hye Park, Yong Su Jang, Hyun Kim, Sung Oh Hwang

¹Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea. ed119@yonsei.ac.kr
²Department of Laboratory Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.

외상성 뇌손상 환자에 있어서 S100β의 혈중 농도와
뇌손상의 정도 및 예후의 관계

김오현·이강현·윤갑준*·박경혜·장용수?김@ 현·황성오

연세대학교 원주의과대학 응급의학과, 진단검사의학과*

Abstract

PURPOSE
S100beta, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. S100beta, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S100beta, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum S100beta, and neurologic outcome, and severity in traumatic brain injury.
METHODS
From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for S100beta, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS).
RESULTS
Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum S100beta, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups (0.74+/-50 microgram/L vs 7.62+/-6.53 microgram/L P=0.002). A negative correlation existed between serum S100beta, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum S100beta, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlations between serum S100beta, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of S100beta. was 7.62 beta partial differential/L (SD=+/-6.53) in the expired patients, 1.15 microgram/L in the mildly disable patient, and 0.727 microgram/L (SD=+/-0.73) in the recovered patients. These differences are statistically significant (p<0.001).
CONCLUSION
In traumatic brain injury, a higher level of serum concentration of S100beta, has a poor prognosis for neurologic outcome.

Key Words: S100beta protein; Traumatic brain injury; Serum marker

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