S100B protein: a possible prognostic factor in patients with a severe head trauma injury

Introduction

S100B protein is a small protein that belongs to the group of calcium binding proteins. It is present in high concentrations in astroglia cells. The level of this marker increases significantly with CNS damage. Normal value is 0–0.2 μg/l.

Aim

The aim of our research was to evaluate a consequence of a dynamic monitoring of the S100B protein levels for a prognosis of patients with severe head trauma injury.

Method

Thirty patients with severe head trauma injury were prospectively monitored. All patients were admited to the Emergency Department. The time period from injury to admission was shorter than 6 hours. All patients had the initial CT scan of the brain performed with a positive finding. We used these scoring protocols: at admission GCS, APACHE II, at dismissal GOS, Karnofsky Performance Score (KPS). S100B protein level was done by LIA essay on a fully automated immunoanalyser (Liaison; DiaSorin, Sweden).

Results

We divided our patients into four groups according to characteristics of the S100B protein levels. The average values of the particular groups are given in Table 1: group A, patients with a rapid decrease of the level; group B, patients with an increasing or persistent high level; group C, patients with a repeated increase of the level after a previous decrease; group D, patients with an initial level above 5 μg/l.

Table 1

Conclusion

A rapid decrease of the level in the first 72 hours is associated with a good prognosis. Increasing or persistent high levels longer than 72 hours are associated with a poor prognosis. A repeated increase level above 1 μg/l after a previous decrease is associated with a poorer outcome. An initial level above 5 μg/l is associated with death.