Plasma-based S100B testing for management of traumatic brain injury in emergency setting.
Integrated diagnostics
Mild head injury
Mild traumatic brain injury
Plasma
S100B
Serum biomarker
Traumatic brain injury
Journal
Practical laboratory medicine
ISSN: 2352-5517
Titre abrégé: Pract Lab Med
Pays: Netherlands
ID NLM: 101690848
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
17
11
2020
accepted:
07
05
2021
entrez:
27
5
2021
pubmed:
28
5
2021
medline:
28
5
2021
Statut:
epublish
Résumé
Serum biomarker S100B has been explored for its potential benefit to improve clinical decision-making in the management of patients suffering from traumatic brain injury (TBI), especially as a pre-head computed-tomography screening test for patients with mild TBI. Although being already included into some guidelines, its implementation into standard care is still lacking. This might be explained by a turnaround time (TAT) too long for serum S100B to be used in clinical decision-making in emergency settings. S100B concentrations were determined in 136 matching pairs of serum and lithium heparin blood samples. The concordance of the test results was assessed by linear regression, Passing Pablok regression and Bland-Altman analysis. Bias and within- and between-run imprecision were determined by a 5 × 4 model using pooled patient samples. CT scans were performed as clinically indicated. Overall, S100B levels between both blood constituents correlated very well. The suitability of S100B testing from plasma was verified according to ISO15189 requirements. Using a cut-off of 0.105 ng/ml, a sensitivity and negative predictive value of 100% were obtained for identifying patients with pathologic CT scans. Importantly, plasma-based testing reduced the TAT to 26 min allowing for quicker clinical decision-making. The clinical utility of integrating S100B in TBI management is highlighted by two case reports. Plasma-based S100B testing compares favorably with serum-based testing, substantially reducing processing times as the prerequisite for integrating S100B level into management of TBI patients. The proposed new clinical decision algorithm for TBI management needs to be validated in further prospective large-scale studies.
Sections du résumé
BACKGROUND
BACKGROUND
Serum biomarker S100B has been explored for its potential benefit to improve clinical decision-making in the management of patients suffering from traumatic brain injury (TBI), especially as a pre-head computed-tomography screening test for patients with mild TBI. Although being already included into some guidelines, its implementation into standard care is still lacking. This might be explained by a turnaround time (TAT) too long for serum S100B to be used in clinical decision-making in emergency settings.
METHODS
METHODS
S100B concentrations were determined in 136 matching pairs of serum and lithium heparin blood samples. The concordance of the test results was assessed by linear regression, Passing Pablok regression and Bland-Altman analysis. Bias and within- and between-run imprecision were determined by a 5 × 4 model using pooled patient samples. CT scans were performed as clinically indicated.
RESULTS
RESULTS
Overall, S100B levels between both blood constituents correlated very well. The suitability of S100B testing from plasma was verified according to ISO15189 requirements. Using a cut-off of 0.105 ng/ml, a sensitivity and negative predictive value of 100% were obtained for identifying patients with pathologic CT scans. Importantly, plasma-based testing reduced the TAT to 26 min allowing for quicker clinical decision-making. The clinical utility of integrating S100B in TBI management is highlighted by two case reports.
CONCLUSIONS
CONCLUSIONS
Plasma-based S100B testing compares favorably with serum-based testing, substantially reducing processing times as the prerequisite for integrating S100B level into management of TBI patients. The proposed new clinical decision algorithm for TBI management needs to be validated in further prospective large-scale studies.
Identifiants
pubmed: 34041343
doi: 10.1016/j.plabm.2021.e00236
pii: S2352-5517(21)00036-6
pmc: PMC8141926
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e00236Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
The authors have declared no conflicts of interest.
Références
Clin Chem Lab Med. 2015 Jul;53(8):1161-71
pubmed: 25720082
Postgrad Med J. 2017 Aug;93(1102):454-459
pubmed: 28011895
BMC Med. 2015 Dec 09;13:292
pubmed: 26645914
Eur J Trauma Emerg Surg. 2019 May 14;:
pubmed: 31089789
Eur J Med Res. 2002 Apr 30;7(4):164-70
pubmed: 12010651
J Neurotrauma. 2005 Dec;22(12):1419-27
pubmed: 16379580
J Head Trauma Rehabil. 2010 Jul-Aug;25(4):228-40
pubmed: 20611042
J Emerg Nurs. 2009 Apr;35(2):e5-40
pubmed: 19285163
J Emerg Med. 2003 Feb;24(2):157-62
pubmed: 12609645
JAMA. 2005 Sep 28;294(12):1519-25
pubmed: 16189365
JAMA. 2005 Sep 28;294(12):1511-8
pubmed: 16189364
BMC Med. 2013 Feb 25;11:50
pubmed: 23432764
Diagn Interv Imaging. 2017 Jul - Aug;98(7-8):551-556
pubmed: 28579521
Biochim Biophys Acta. 2009 Jun;1793(6):1008-22
pubmed: 19110011
Ann Oncol. 2009 Aug;20 Suppl 6:vi8-13
pubmed: 19617299
Ann Emerg Med. 2009 Feb;53(2):180-8
pubmed: 18339447
Clin Biochem. 2012 Apr;45(6):408-11
pubmed: 22285378
Acta Neurochir (Wien). 2017 Feb;159(2):209-225
pubmed: 27957604
J Neurotrauma. 2006 Feb;23(2):149-55
pubmed: 16503799
Biochem Med (Zagreb). 2018 Feb 15;28(1):010704
pubmed: 29187797
BMC Neurol. 2016 Oct 20;16(1):200
pubmed: 27765016
J Neurotrauma. 2004 Nov;21(11):1553-61
pubmed: 15684648
J Neurotrauma. 2009 Oct;26(10):1655-64
pubmed: 19413465
Ann Clin Biochem. 2017 Sep;54(5):593-600
pubmed: 27687083
Z Orthop Unfall. 2020 Apr;158(2):201-207
pubmed: 31533168
Ann Oncol. 2010 May;21 Suppl 5:v194-7
pubmed: 20555080
Clin Biochem. 2003 Nov;36(8):629-32
pubmed: 14636878
Ann Emerg Med. 2012 Mar;59(3):209-18
pubmed: 21944878
Lancet. 2001 May 5;357(9266):1391-6
pubmed: 11356436
Shock. 2002 Nov;18(5):395-400
pubmed: 12412616
J Rehabil Med. 2004 Feb;(43 Suppl):28-60
pubmed: 15083870
J Athl Train. 2014 Nov-Dec;49(6):830-50
pubmed: 25299445
Front Neurol. 2019 Apr 26;10:446
pubmed: 31105646
N Engl J Med. 2000 Jul 13;343(2):100-5
pubmed: 10891517
Acta Radiol. 2013 Jun;54(5):592-8
pubmed: 23481653
Recenti Prog Med. 2013 Mar;104(3):120-32
pubmed: 23548957