Impact of creatine kinase correction on the predictive value of S-100B after mild traumatic brain injury.

Full Abstract

PURPOSE:
To validate a correction factor for the extracranial release of the astroglial protein, S-100B, based on concomitant creatine kinase (CK) levels.

METHODS:
The CK- S-100B relationship in non-head injured marathon runners was used to derive a correction factor for the extracranial release of S-100B. This factor was then applied to a separate cohort of 96 mild traumatic brain injury (TBI) patients in whom both CK and S-100B levels were measured. Corrected S-100B was compared to uncorrected S-100B for the prediction of initial head CT, three-month headache and three-month post concussive syndrome (PCS).

RESULTS:
Corrected S-100B resulted in a statistically significant improvement in the prediction of 3-month headache (area under curve [AUC] 0.46 vs 0.52, p=0.02), but not PCS or initial head CT. Using a cutoff that maximizes sensitivity (> or = 90%), corrected S-100B improved the prediction of initial head CT scan (negative predictive value from 75% [95% CI, 2.6%, 67.0%] to 96% [95%

CI:
83.5%, 99.8%]).

CONCLUSIONS:
Although S-100B is overall poorly predictive of outcome, a correction factor using CK is a valid means of accounting for extracranial release. By increasing the proportion of mild TBI patients correctly categorized as low risk for abnormal head CT, CK-corrected S100-B can further reduce the number of unnecessary brain CT scans performed after this injury.

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Author information

Author/s: Bazarian, Jeffrey J (JJ); Beck, Christopher (C); Blyth, Brian (B); von Ahsen, Nicolas (N); Hasselblatt, Martin (M);

Affiliation: Department of Emergency Medicine, University of Rochester School of Medicine, Rochester, NY, USA. jeff_bazarian(-atsign-)urmc.rochester.edu

Grants: 1K23NS41952-05 (Agency:NINDS NIH HHS)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies

Journal: Restorative neurology and neuroscience (Restor Neurol Neurosci), published in Netherlands. (Language: eng)

Reference: 2006-; vol 24 (issue 3) : pp 163-72

Dates: Created 2006/07/28; Completed 2006/09/19; Revised 2007/11/14;

PMID: 16873971, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Aged
Area Under Curve
Brain Injuries - blood
Child
Cohort Studies
Creatine Kinase - blood
Female
Headache - blood

Associated Chemicals: S100 Proteins (0) ; Creatine Kinase (EC 2.7.3.2)

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