Brain & spine · 2026
Temporal dynamics of serum S100β as a prognostic indicator in aneurysmal subarachnoid hemorrhage: A prospective cohort study including comparison of clipping and endovascular treatment.
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Geiger P, Treichl S A, Ho W, Preuss-Hernandez C, Pinggera D, Thomé C, Petr O
Аннотация
INTRODUCTION: S100β is an astrocyte-derived calcium-binding protein with prognostic utility after brain injury. Its temporal profile in aneurysmal subarachnoid hemorrhage (aSAH) and the influence of peri-procedural factors on serum levels remain incompletely characterized.
RESEARCH QUESTION: (1) Are serial serum S100β concentrations associated with six-month functional outcome after aSAH? (2) Do S100β trajectories differ between surgical clipping and endovascular treatment, compared with an elective unruptured aneurysm cohort as a procedural reference?
METHODS: This prospective single-center cohort study enrolled 100 adults (50 aSAH; 50 elective unruptured aneurysm treatments). Venous blood was sampled pre-intervention and repeatedly through day 10. S100β was measured using the Elecsys® S100 assay (Roche). Six-month outcome was assessed with the Glasgow Outcome Scale, dichotomized as favorable (4-5) vs. unfavorable (1-3). Nonparametric comparisons and logistic regression evaluated associations between S100β, treatment modality, and outcome.
RESULTS: Baseline S100β was higher in aSAH than elective controls (median 0.19 vs. 0.08 μg/L; p < 0.001). Surgical clipping was associated with higher early post-procedural S100β than endovascular treatment through day 2, with no clear difference thereafter. Higher pre- and early post-intervention S100β values were associated with unfavorable six-month outcome. Treatment modality itself was not associated with outcome.
CONCLUSION: Serial S100β elevations during acute aSAH were associated with unfavorable long-term outcome, supporting S100β as a candidate prognostic marker rather than a validated standalone biomarker. Early post-procedural S100β elevations after surgical clipping were transient and may reflect peri-procedural glial activation, baseline severity differences, and other confounding factors. These exploratory findings require confirmation in larger, adequately adjusted multicenter cohorts before clinical prognostic implementation.
RESEARCH QUESTION: (1) Are serial serum S100β concentrations associated with six-month functional outcome after aSAH? (2) Do S100β trajectories differ between surgical clipping and endovascular treatment, compared with an elective unruptured aneurysm cohort as a procedural reference?
METHODS: This prospective single-center cohort study enrolled 100 adults (50 aSAH; 50 elective unruptured aneurysm treatments). Venous blood was sampled pre-intervention and repeatedly through day 10. S100β was measured using the Elecsys® S100 assay (Roche). Six-month outcome was assessed with the Glasgow Outcome Scale, dichotomized as favorable (4-5) vs. unfavorable (1-3). Nonparametric comparisons and logistic regression evaluated associations between S100β, treatment modality, and outcome.
RESULTS: Baseline S100β was higher in aSAH than elective controls (median 0.19 vs. 0.08 μg/L; p < 0.001). Surgical clipping was associated with higher early post-procedural S100β than endovascular treatment through day 2, with no clear difference thereafter. Higher pre- and early post-intervention S100β values were associated with unfavorable six-month outcome. Treatment modality itself was not associated with outcome.
CONCLUSION: Serial S100β elevations during acute aSAH were associated with unfavorable long-term outcome, supporting S100β as a candidate prognostic marker rather than a validated standalone biomarker. Early post-procedural S100β elevations after surgical clipping were transient and may reflect peri-procedural glial activation, baseline severity differences, and other confounding factors. These exploratory findings require confirmation in larger, adequately adjusted multicenter cohorts before clinical prognostic implementation.