From the Journals

S100B biomarker could reduce CT scans in children with mTBI



Using biomarker S100B routinely could significantly reduce computed tomography (CT) scans performed on children with mild traumatic brain injury (mTBI), according to Charlotte Oris, PharmD, of the University Hospital of Clermont-Ferrand, France, and her associates.

In a meta-analysis of eight prospective cohort studies including a total of 601 children published in Pediatrics, researchers looked at the association between S100B serum levels and CT findings in 373 patients. The median serum concentrations of S100B were 0.47 mcg/L for patients with intracerebral lesions and 0.21 mcg/L for those without lesions (P less than .001).

Additionally, researchers collected data from 358 individuals included in two studies for the origin of mTBI. The median concentrations of S100B were 0.39 mcg/L for road accidents, 0.29 mcg/L for domestic accidents, and 0.18 mcg/L for sport-related accidents. The difference was statistically significant between the road accidents group and the domestic accidents group (P less than .001) and the difference between the road accidents group and the sport-related accidents group (P less than .001). It is noted that S100B specificity could be higher after a sport-related trauma.

ā€œS100B protein serum levels, in combination with the PECARN [Pediatric Emergency Care Applied Research Network] algorithm, could reduce the need for CT scans by one-third. In our additional analysis, based on 373 children, the importance of taking a blood sample 3 hours or less after trauma was underscored,ā€ the researchers said.

ā€œS100B represents a promising biomarker with 100% sensitivity. The limited specificity of S100B could be reevaluated for future research by using a combination of different brain biomarkers,ā€ Dr. Oris and her colleagues concluded.

SOURCE: Oris C et al. Pediatrics. 2018. doi: 10.1542/peds.2018-0037.

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