Temporal Changes in Serum S100B Levels From Prehospital to Early In-Hospital Sampling in Patients Suffering Traumatic Brain Injury

Sophie Charlott Seidenfaden*, Julie Linding Kjerulff, Niels Juul, Hans Kirkegaard, Mette Fogh Møller, Anna Marie Bloch Münster, Morten Thingemann Bøtker


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Background: The biomarker S100B is used for the rule-out of intracranial lesions in patients with mild traumatic brain injury (TBI) and is suggested for prehospital use in Europe. Early kinetics of S100B are not exhaustively investigated in human TBI. This post hoc descriptive study of the data from the PreTBI studies aimed to characterize the early temporal changes of S100B using two-sample timepoints. Materials and Methods: Two consecutive blood samples were taken prehospital and in-hospital after injury and assayed for S100B. The endpoint adjudication of the outcome intracranial lesion was done by the evaluation of electronic medical patient journals. The data were analyzed using descriptive statistics, scatterplots, and temporal changes estimated by the locally weighted scatterplot smoothing (LOWESS) regression line. Results: A total of 592 adult patients with TBI were included; 566 with Glasgow Coma Scale (GCS) 14-15, 20 with GCS 9-13, and 6 with GCS 3-8. Intracranial lesions were diagnosed in 44/566 (7.4%) of patients. In 90% of patients, S100B concentrations decreased from prehospital to in-hospital sampling. The mean decrease was−0.34 μg/L. S100B concentrations seem to decline already within 60 min. Patients sampled very close to trauma and patients suffering intracranial lesions may express a slight incline before this decline. Temporal changes of S100B did not differ in patients >65 years of age, in antiplatelet/-coagulant treatment, alcohol intoxicated, or suffering extra-cranial injuries. Conclusion: S100B concentrations may peak earlier than expected from previous studies of temporal changes in human TBI. Patterns of S100B stand robust to parameters stated as limiting factors to the use for early rule-out of intracranial lesions in the current guidelines. Further studies are needed to investigate the ultra-early temporal profiles of other novel TBI biomarkers to assess prehospital applicability and optimal diagnostic performance in TBI.

TidsskriftFrontiers in Neurology
Antal sider11
StatusUdgivet - 8. apr. 2022

Bibliografisk note

Funding Information:
The PreTBI I, II, and III studies were entirely initiated by the research group. No commercial companies were involved in the design or initiation of the study. The salary for primary investigator amounts to the regular PhD salary throughout the study period. The project was financially supported by external foundations: The A.P. Møller and Chastine Mc-Kinney Møller Foundation for General Purposes (Medical Foundation) (DKK 60.000), Holger and Ruth Hesse Memorial Foundation (DKK 64.000), Central Denmark Region Health Research Foundation (DKK 480.000), The Civil Affairs Agency, Danish Ministry of Justice (Offerfonden) (DKK 600.000), and The Danish Air Ambulance (480.000). The Regional Scientific Ethical Committee System was notified of all funding during the study period.

Funding Information:
We thank all participating ambulance personnel from Falck A/S and Response A/S and the entire Prehospital EMS, Central Denmark Region. The authors thank all participating departments in the Central Denmark Region, namely, Charlotte Bjerregaard and Nikolaj Raaber for obtaining informed consent. The authors also thank Hanne Kierkegaard, Sanne Seidelin Langhoff, Trine Meinby S?rensen, and Tina Windfeld for laboratory work, Claus Kj?r Pedersen for great advice and support when establishing blood sampling procedures and maintaining the biological bank, and Ingunn S. Riddervold for vital support in planning and launching this study.

Publisher Copyright:
Copyright © 2022 Seidenfaden, Kjerulff, Juul, Kirkegaard, Fogh Møller, Bloch Münster and Thingemann Bøtker.


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