The Usefulness of Serum S-100 beta Levels as a Screening Test for Pediatric Minor Head Trauma

Bak,  Hyeun Uk; Sung,  Won Young; Lee,  Jang Young; Kim,  Ji Myung; Hong,  Seung Yup; Yang,  Young Mo; Yi,  Hwa Yeon

J Korean Soc Emerg Med > Volume 19(2); 2008 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2008;19(2): 185-191.

The Usefulness of Serum S-100 beta Levels as a Screening Test for Pediatric Minor Head Trauma

Hyeun Uk Bak, Won Young Sung, Jang Young Lee, Ji Myung Kim, Seung Yup Hong, Young Mo Yang, Hwa Yeon Yi

¹Department of Emergency Medicine, College of Medicine, Eulji University, Deajon, Korea. pons1224@hanmail.net
²Department of Laboratory Medicine, College of Medicine, Eulji University, Deajon, Korea.
³Department of Emergency Medicine, College of Medicine, Chungnam National University, Deajon, Korea.

ABSTRACT

PURPOSE:
It is well known that serum S-100 beta protein levels increased in adults after brain injury. However, there is no definite clinical data in children with isolated minor head trauma. The present study was conducted to validate S-100 beta protein levels as a screening test for brain damage in children with minor head trauma.
METHODS:
Serum S-100 beta protein levels were measured in 48 pediatric patients with minor head trauma. All patients had brain computed tomography (CT) scan to confirm brain injury. Data were analyzed using a contingency table and a receiver operating characteristic (ROC) curve to determine the diagnostic value of S-100 beta protein levels.
RESULTS:
Twelve (25%) patients had abnormal brain CT findings. Using a concentration cutoff value of 0.12 ug/L, patients with abnormal brain CT findings were identified by S-100 beta protein levels measurement with a sensitivity level of 100% and a specificity 38.9%. The area under the ROC curve for S-100 beta protein levels was 0.758 (95% CI, 0.606- 0.910). The number of high risk factors were 2.35+/-1.23 in the positive group and 1.53+/-0.76 in the negative group (p=0.011).
CONCLUSION:
Serum S-100 beta protein levels in children with minor head trauma were similar to those of adults. Our study supports the contention that rapid assessment of serum S-100 beta protein levels may reduce the use of brain CT in children with minor head trauma.

Key words: S100 Proteins, Tomography, Head Injuries, Closed, Pediatrics