Brain injury · 2022
Biomarker S100B in plasma a screening tool for mild traumatic brain injury in an emergency department.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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H Hopman Joëlla, A L Santing Juliette, A Foks Kelly, J Verheul Rolf, M van der Linden Christien, L van den Brand Crispijn, Jellema Korné
Аннотация
INTRODUCTION: A computerized tomography (CT) scan is an effective test for detecting traumatic intracranial findings after mild traumatic brain injury (mTBI). However, a head CT is costly, and can only be performed in a hospital.
OBJECTIVE: To determine if the addition of plasma S100B to clinical guidelines could lead to a more selective scanning strategy without compromising safety.
METHODS: We conducted a single center prospective cohort study at the emergency department. Patients (≥16 years) who received head CT and had a blood draw were included. The primary outcome was the accuracy of plasma S100B to predict the presence of any traumatic intracranial lesion on head CT.
RESULTS: We included 495 patients, out of the 74 patients who had traumatic intracranial lesions, 5 patients had a plasma S100B level below the cutoff value of 0.105 ug/L. For the detection of traumatic intracranial injury, S100B had a sensitivity of 0.932 , a specificity of 0.157, a negative predictive value of 0.930, and a positive predictive value of 0.163.
CONCLUSIONS: Among patients undergoing guideline-based CT scan for mTBI, the use of S100B, would results in a further decrease (14.8%) of CT scans but at a cost of missed injury, without clinical consequence, on CT.
OBJECTIVE: To determine if the addition of plasma S100B to clinical guidelines could lead to a more selective scanning strategy without compromising safety.
METHODS: We conducted a single center prospective cohort study at the emergency department. Patients (≥16 years) who received head CT and had a blood draw were included. The primary outcome was the accuracy of plasma S100B to predict the presence of any traumatic intracranial lesion on head CT.
RESULTS: We included 495 patients, out of the 74 patients who had traumatic intracranial lesions, 5 patients had a plasma S100B level below the cutoff value of 0.105 ug/L. For the detection of traumatic intracranial injury, S100B had a sensitivity of 0.932 , a specificity of 0.157, a negative predictive value of 0.930, and a positive predictive value of 0.163.
CONCLUSIONS: Among patients undergoing guideline-based CT scan for mTBI, the use of S100B, would results in a further decrease (14.8%) of CT scans but at a cost of missed injury, without clinical consequence, on CT.