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KMID : 0385920060170060574
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Journal of the Korean Society of Emergency Medicine
2006 Volume.17 No. 6 p.574 ~ p.580
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The Clinical Value of Serum S-100B Protein Measurements in Treating Minor Head Injury
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Kim Chan-Woong
Kim Hye-Ryoun
Lee Mi-Kyung
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Abstract
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Purpose: Ninety percent of patients with minor head injury(MHI) who undergo computed tomography (CCT) under current clinical decision rules have normal scans. Serum concentrations of astroglial protein S-100B were recently found to provide useful information in such cases, but there is no clinical data in this country. We have investigated whether S-100B concentrations in alert patients with MHI can serve as an indicator of the need for an initial CCT scan.
Methods: 40 patients with MHI and a control group of 54 healthy volunteers were enrolled in this prospective study. All patients with MHI had a CCT scan to confirm diagnosis, and blood was drawn from all study participants in order to measure S-100B concentrations. Data were analyzed using contingency table and a receiver operating characteristic (ROC) curve to determine the diagnostic value of S-100B.
Results: Using a concentration cutoff of 0.12 g/L, patients with abnormal CCT findings were identified by S-100B measurement with a sensitivity level of 100% and a specificity level of 46%. S-100B concentrations for head injury patients with multiple trauma were increased more than for patients without combined injuries.
Conclusion: Adding measurement of S-100B concentration to the clinical decision rules for a CCT scan in alert patients with MHI could allow a 46% reduction in scans in our study. However, before S-100B testing can be used clinically, larger domestic trials conforming to all appropriate ethical guidelines need to be conducted in the near future.
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KEYWORD
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S-100 protein, Computed tomography, Minor head injury
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