Gautier Allouchery1, Farès Moustafa2, Jean Roubin2, Bruno Pereira3, Jeannot Schmidt2, Julien Raconnat2, Daniel Pic2, Vincent Sapin1,4, Damien Bouvier1,4,5. 1. CHU Clermont-Ferrand, Biochemistry and Molecular Genetic Department, Clermont-Ferrand, France. 2. CHU Clermont-Ferrand, Adult Emergency Department, Clermont-Ferrand, France. 3. CHU Clermont-Ferrand, Biostatistics Unit (DRCI) Department, Clermont-Ferrand, France. 4. Université Clermont Auvergne, CNRS, INSERM, GReD, Clermont-Ferrand, France. 5. Laboratoire de Biochimie Médicale, Centre de Biologie, CHU Gabriel Montpied, 58 Rue Montalembert, 63000 Clermont-Ferrand, France.
Abstract
BACKGROUND: This study's primary objective was to validate the routine use of S100B via a prospective study. The aim was a reduction of cranial computed tomography (CCT) scans by 30%. The secondary goal was to investigate the influence of age and associated risk factors on the reduction of CCT. METHODS: S100B (sampling within 3 h postinjury) was used for patients with mild traumatic brain injury (mTBIs) presenting a medium risk of complications and requiring a CCT scan. Patients with negative S100B (S100B-) were discharged without a CCT scan. RESULTS: Of the 1449 patients included in this study, 468 (32.3%) had S100B- with a sensitivity of 96.4% (95% CI: 87.5%-99.6%), a specificity of 33.4% (95% CI: 31%-36%) and a negative predictive value of 99.6% (95% CI: 98.5%-99.9%). No significant difference in serum levels or the S100B+ rate was observed if patients had retrograde amnesia (0.16 μg/L; 63.8%), loss of consciousness (0.13; 63.6%) or antiplatelet therapy (0.20; 77.9%). Significant differences were found between the S100B concentrations and S100B positivity rates in patients >65 years old and all the groups with patients <55 years old (18-25, 26-35, 36-45 and 46-55). From 18 to 65 years old (n=874), the specificity is 39.3% (95% CI: 36%-42.6%) compared to 18.7% (95% CI: 15.3%-22.3%) for patients >65 years old (n=504). CONCLUSIONS: The clinical use of S100B in mTBI management reduces the use of CCTs by approximately one-third; furthermore, the percentage of CCTs reduction is influenced by the age of the patient.
BACKGROUND: This study's primary objective was to validate the routine use of S100B via a prospective study. The aim was a reduction of cranial computed tomography (CCT) scans by 30%. The secondary goal was to investigate the influence of age and associated risk factors on the reduction of CCT. METHODS:S100B (sampling within 3 h postinjury) was used for patients with mild traumatic brain injury (mTBIs) presenting a medium risk of complications and requiring a CCT scan. Patients with negative S100B (S100B-) were discharged without a CCT scan. RESULTS: Of the 1449 patients included in this study, 468 (32.3%) had S100B- with a sensitivity of 96.4% (95% CI: 87.5%-99.6%), a specificity of 33.4% (95% CI: 31%-36%) and a negative predictive value of 99.6% (95% CI: 98.5%-99.9%). No significant difference in serum levels or the S100B+ rate was observed if patients had retrograde amnesia (0.16 μg/L; 63.8%), loss of consciousness (0.13; 63.6%) or antiplatelet therapy (0.20; 77.9%). Significant differences were found between the S100B concentrations and S100B positivity rates in patients >65 years old and all the groups with patients <55 years old (18-25, 26-35, 36-45 and 46-55). From 18 to 65 years old (n=874), the specificity is 39.3% (95% CI: 36%-42.6%) compared to 18.7% (95% CI: 15.3%-22.3%) for patients >65 years old (n=504). CONCLUSIONS: The clinical use of S100B in mTBI management reduces the use of CCTs by approximately one-third; furthermore, the percentage of CCTs reduction is influenced by the age of the patient.
Authors: William R McBride; Caroline E Conlan; Nicole A Barylski; Amelie C Warneryd; Randel L Swanson Journal: Curr Phys Med Rehabil Rep Date: 2022-02-26
Authors: Jamie Kearns; Aisling M Ross; Darragh R Walsh; Rachel M Cahalane; Rita Hinchion; Maria C Ryan; Elaine Conway; Tom M Comyns; Ian C Kenny; Eibhlís M O'Connor; Kieran D McGourty; John Joseph Eugene Mulvihill Journal: BMJ Open Sport Exerc Med Date: 2020-11-26
Authors: Julien Blais Lécuyer; Éric Mercier; Pier-Alexandre Tardif; Patrick M Archambault; Jean-Marc Chauny; Simon Berthelot; Jérôme Frenette; Jeff Perry; Ian Stiell; Marcel Émond; Jacques Lee; Eddy Lang; Andrew McRae; Valérie Boucher; Natalie Le Sage Journal: Emerg Med J Date: 2020-12-18 Impact factor: 2.740