Association of ICP, CPP, CT findings and S-100B and NSE in severe traumatic head injury. Prognostic value of the biomarkers
2015 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 29, no 4, 446-454 p.Article in journal (Refereed) Published
Objective: The association was studied of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) on S-100B and neuron-specific enolase (NSE) in severe traumatic brain injury (sTBI). The relationship was explored between biomarkers, ICP, CPP, CT-scan classifications and the clinical outcome.
Materials and methods: Data were collected prospectively and consecutively in 48 patients with Glasgow Coma Scale score ≤ 8, age 15–70 years. NSE and S-100B were analysed during 5 consecutive days. The initial and follow-up CT-scans were classified according to the Marshall, Rotterdam and Morris-Marshall classifications. Outcome was evaluated with extended Glasgow outcome scale at 3 months.
Results: Maximal ICP and minimal CPP correlated with S-100B and NSE levels. Complex relations between biomarkers and CT classifications were observed. S-100B bulk release (AUC = 0.8333, p = 0.0009), and NSE at 72 hours (AUC = 0.8476, p = 0.0045) had the highest prediction power of mortality. Combining Morris-Marshall score and S-100B bulk release improved the prediction of clinical outcome (AUC = 0.8929, p = 0.0008).
Conclusion: Biomarker levels are associated with ICP and CPP and reflect different aspects of brain injury as evaluated by CT-scan. The biomarkers might predict mortality. There are several pitfalls influencing the interpretation of biomarker data in respect to ICP, CPP, CT-findings and clinical outcome.
Place, publisher, year, edition, pages
2015. Vol. 29, no 4, 446-454 p.
CPP, CT classification, ICP targeted therapy, ICP, NSE, prognostication, S-100B, severe traumatic brain jury
IdentifiersURN: urn:nbn:se:umu:diva-103228DOI: 10.3109/02699052.2014.989403ISI: 000352803300005PubMedID: 25518864OAI: oai:DiVA.org:umu-103228DiVA: diva2:812484