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The prognostic value of serum S-100B protein in spontaneous subarachnoid haemorrhage

Lookup NU author(s): Emeritus Professor David Mendelow

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Abstract

Background. Despite the major progress in neurophysiological monitoring, there are still difficulties in the early identification and quantification of cerebral damage after a stroke. In this prospective study we examined the associations between serum S-100B protein, a serum marker of brain injury, and initial neurological-neuroimaging severity, secondary deterioration, external ventricular drainage (EVD: therapeutic intervention) and outcome in patients with subarachnoid haemorrhage (SAH). Method. We recorded all pertinent clinical data of 52 patients with SAH and measured S-100B serum levels on admission and every 24 h for a maximum of 9 consecutive days. Mann-Whitney U-test and Kruskal Wallis analysis were employed to assess the association of S-100B levels with all variables of interest. Log-rank test was used to evaluate survival and Cox's proportional hazard regression analysis to define the significant predictors of survival rate. Findings. Admission S-100B was statistically significantly associated with initial neurological status, neuroimaging severity, and one-year outcome (p = 0.0002, 0.001, and 0.017, Kruskal Wallis analysis). Admission S-100B above 0.3 mu/L predicted unfavourable outcome (p < 0.0001, log rank test) and constituted an independent predictor of short-term survival (p = 0.035 Cox's proportional hazard regression analysis) with a hazard ratio of 2.2 (95% C.I.: 1.06-4.6) indicating a more than doubling of death probability. Secondary neurological deterioration associated with S-100B increase (p < 0.0001) and external ventricular drainage (EVD) with S-100B reduction (p = 0.003, Wilcoxon signed rank test). Conclusions. Serum S-100B protein seems to be a useful biochemical indicator of neurological - neuroimaging severity, secondary deterioration, EVD (therapeutic intervention), and outcome in patients with SAH.

Publication metadata

Author(s): Stranjalis G, Korfias S, Psachoulia C, Kouyialis A, Sakas DE, Mendelow AD

Publication type: Article

Publication status: Published

Journal: Acta Neurochirurgica

Year: 2007

Volume: 149

Issue: 3

Pages: 231-238

ISSN (print): 0001-6268

ISSN (electronic): 0942-0940

Publisher: Springer Wien

URL: http://dx.doi.org/10.1007/s00701-006-1106-9

DOI: 10.1007/s00701-006-1106-9

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