The Clinical Value of Serum S-100B Protein Measurements in Treating Minor Head Injury

Kim,  Chan Woong; Kim,  Hye Ryoun; Lee,  Mi Kyung

J Korean Soc Emerg Med > Volume 17(6); 2006 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2006;17(6): 574-580.

The Clinical Value of Serum S-100B Protein Measurements in Treating Minor Head Injury

Chan Woong Kim, Hye Ryoun Kim, Mi Kyung Lee

Department of Emergency Medicine, Department of Laboratory Medicine1, YongSan Hospital, ChungAng University, Seoul, Korea. whenever@cau.ac.kr

ABSTRACT

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 microgram/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.

Key words: S-100 protein, Computed tomography, Minor head injury