Article

Prognosis Value of Plasma S100B Protein Levels after Subarachnoid Aneurysmal Hemorrhage

Department of Anesthesiology and Critical Care, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.
Anesthesiology (Impact Factor: 5.88). 05/2006; 104(4):658-66. DOI: 10.1097/00000542-200604000-00008
Source: PubMed

ABSTRACT

S100B has been described as a biologic marker of neuronal damage. The purpose of this study was to assess its prognostic value in patients with subarachnoid aneurysmal hemorrhage.
Seventy-four patients (32 men and 42 women; age, 48 +/- 11 yr) admitted within 48 h after subarachnoid hemorrhage onset and treated by surgical clipping or coiling within 2 days after admission were included. World Federation of Neurological Surgeons, Fisher, and Glasgow outcome scores at intensive care unit discharge and at 6 months were evaluated. Blood concentrations of S100B were determined at admission and daily up to day 8.
The time course of S100B was increased in patients with high World Federation of Neurological Surgeons and Fisher scores. Patients who underwent surgical clipping had an S100B time course longer than that of those who underwent coiling. This difference remained true after stratification for World Federation of Neurological Surgeons and Fisher scores. The threshold of mean daily value of S100B predicting a poor outcome at 6 months was 0.4 microg/l (sensitivity = 0.50 [95% confidence interval (CI), 0.29-0.71], specificity = 0.87[corrected] [95% CI, 0.76-0.95]). In multivariate analysis, high World Federation of Neurological Surgeons score (odds ratio = 9.5 [95% CI, 3.1-29.4]), mean daily S100B value above 0.4 microg/l (odds ratio = 7.3 [95% CI, 2.3-23.6]), and age (odds ratio = 1.08 per year [95% CI, 1.01-1.15]) were independent predictors of a poor 6-month outcome (Glasgow outcome score 1-3).
Mean daily value of S100B assessed during the first 8 days is a prognostic tool complementary to initial clinical evaluation in subarachnoid hemorrhage patients.

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    • "The concentration of these markers has been shown to increase in the cerebrospinal fluid (CSF) as well as in the serum [39-43]. In addition, in patients with SAH the course of the S100B concentration has been shown to correlate with neurologic deficits and outcome [44,45]. "
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    • "2006 S100B First 3 days after SAH TCD ↑ NE NE + ↑ NSE NE NE ↓ Weiss et al. [22] 2006 S100B First 8 days after SAH TCD + arteriography − NE NE ++ No NSE detection (only CVS + S100B < 0.4 í µí¼‡g/L: no death) Sanchez-Pẽ na et al. [23] 2008 S100B First 15 days after SAH TCD + arteriography ↑ in " ischemic vasospasm " patients ++ (↑) No NSE detection (only mean 15 day S100B value) Moritz et al. [24] 2010 S100B Daily during ICU stay TCD − CT ++ ++ NSE − CT + + (only NSE peak value) "
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    • "In clinical practice, it is a reliable biochemical marker of cerebral damage and is also utilized in postmortem diagnosis in medico-legal autopsy cases (28). Because S100B protein plasma levels have been shown to increase during ischemic stroke, S100 protein serum levels are used in clinical practice to monitor neurovascular status and functional outcome in subjects affected by cerebral damage (29) or subarachnoid hemorrhage (30,31). Elevated serum S100B levels have been reported in patients affected by obstructive sleep apnea syndrome (32). "
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Questions & Answers about this publication

  • Leiv Arne Rosseland asked a question in Biomarker Analysis:
    Does anyone use S100B day to day as a biomarker?
    Does anyone use S100B day to day as a biomarker?
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      [Show abstract] [Hide abstract]
      ABSTRACT: S100B has been described as a biologic marker of neuronal damage. The purpose of this study was to assess its prognostic value in patients with subarachnoid aneurysmal hemorrhage. Seventy-four patients (32 men and 42 women; age, 48 +/- 11 yr) admitted within 48 h after subarachnoid hemorrhage onset and treated by surgical clipping or coiling within 2 days after admission were included. World Federation of Neurological Surgeons, Fisher, and Glasgow outcome scores at intensive care unit discharge and at 6 months were evaluated. Blood concentrations of S100B were determined at admission and daily up to day 8. The time course of S100B was increased in patients with high World Federation of Neurological Surgeons and Fisher scores. Patients who underwent surgical clipping had an S100B time course longer than that of those who underwent coiling. This difference remained true after stratification for World Federation of Neurological Surgeons and Fisher scores. The threshold of mean daily value of S100B predicting a poor outcome at 6 months was 0.4 microg/l (sensitivity = 0.50 [95% confidence interval (CI), 0.29-0.71], specificity = 0.87[corrected] [95% CI, 0.76-0.95]). In multivariate analysis, high World Federation of Neurological Surgeons score (odds ratio = 9.5 [95% CI, 3.1-29.4]), mean daily S100B value above 0.4 microg/l (odds ratio = 7.3 [95% CI, 2.3-23.6]), and age (odds ratio = 1.08 per year [95% CI, 1.01-1.15]) were independent predictors of a poor 6-month outcome (Glasgow outcome score 1-3). Mean daily value of S100B assessed during the first 8 days is a prognostic tool complementary to initial clinical evaluation in subarachnoid hemorrhage patients.
      Full-text · Article · May 2006 · Anesthesiology