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Published on: September 22, 2023
Serum S100B Levels Can Predict Computed Tomography Findings in Paediatric Patients with Mild Head Injury
Fatos M Kelmendi1, Arsim A Morina1, Agon Y Mekaj1
1Clinic of Neurosurgery, University Clinical Center of Kosovo, 10000 Pristina, Kosovo.
Insights
Serum S100B levels can help identify children with mild traumatic brain injuries (TBIs) who are at low risk for cranial injury. This biomarker can reduce unnecessary computed tomography (CT) scans and radiation exposure in pediatric patients.
Area of Science:
- Pediatric Traumatology
- Biomarker Discovery
- Medical Imaging
Background:
- Traumatic brain injuries (TBIs) are a significant cause of mortality in children.
- Overreliance on computed tomography (CT) exposes pediatric patients to ionizing radiation, increasing cancer risk.
- There is a need for accurate, non-invasive methods to assess head injuries in children.
Purpose of the Study:
- To evaluate the accuracy of serum S100B protein levels in detecting cranial injuries in children with mild TBI.
- To determine if S100B levels alone can guide decisions on performing CT scans.
- To reduce unnecessary radiation exposure in pediatric TBI cases.
Main Methods:
- A prospective cohort study involving 80 children (ages 2-16) with mild TBI.
- Measurement of serum S100B protein levels in all participants.
- Performance of head CT scans for all patients to confirm cranial injury.
Main Results:
- Patients with cranial injury (head CT+) exhibited significantly higher S100B levels (0.527 μg/L) compared to those without injury (head CT-, 0.145 μg/L) (p < 0.0001).
- Receiver operating characteristic (ROC) analysis demonstrated a strong ability of S100B levels to differentiate between injured and uninjured children at 3 hours post-TBI (AUC = 0.893, p = 0.0001).
Conclusions:
- Serum S100B levels are not a substitute for clinical evaluation or CT in diagnosing pediatric mild head injuries.
- S100B can effectively identify low-risk pediatric patients, thereby preventing unnecessary CT scans and radiation exposure.
- Biomarker-guided assessment holds promise for optimizing diagnostic pathways in pediatric TBI.
Introduction:
Traumatic brain injuries (TBIs) are very common in paediatric populations, in which they are also a leading cause of death. Computed tomography (CT) overuse in these populations results in ionization radiation exposure, which can lead to lethal malignancies. The aims of this study were to investigate the accuracy of serum S100B levels with respect to the detection of cranial injury in children with mild TBI and to determine whether decisions regarding the performance of CT can be made based on biomarker levels alone.
Materials And Methods:
This was a single-center prospective cohort study that was carried out from December 2016 to December 2017. A total of 80 children with mild TBI who met the inclusion criteria were included in the study. The patients were between 2 and 16 years of age. We determined S100B protein levels and performed head CTs in all the patients.
Results:
Patients with cranial injury, as detected by CT, had higher S100B protein levels than those without cranial injury (p < 0.0001). We found that patients with cranial injury (head CT+) had higher mean S100B protein levels (0.527 μg L-1, 95% confidence interval (CI) 0.447-0.607 μg L-1) than did patients without cranial injury (head CT-) (0.145 μg L-1, 95% CI 0.138-0.152 μg L-1). Receiver operating characteristic (ROC) curve analysis clearly showed that S100B protein levels differed between patients with and without cranial injury at 3 hours after TBI (AUC = 0.893, 95% CI 0.786-0.987, p = 0.0001).
Conclusion:
Serum S100B levels cannot replace clinical examinations or CT as tools for identifying paediatric patients with mild head injury; however, serum S100B levels can be used to identify low-risk patients to prevent such patients from being exposed to radiation unnecessarily.
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