[THE LEVEL OF S100Β IN BLOOD SERUM AS A PROGNOSTIC FACTOR OF OUTCOME IN SECONDARY BRAIN LESIONS]

This study is devoted to the study of the prognostic value of neuron-specific markers of the brain and indicators of the outcome of brain damage. The purpose of the study. To study the prognostic role of serum S100 as a predictor of mortality in vascular and traumatic brain injuries.A prospective cohort study involving 219 patients. In the blood serum, neuron-specific markers (S100, NSE) and glucose, acid-base state and gas composition of arterial blood were obtained during follow-up periods: at admission, on the 3rd, 5th and 7th days of patients' stay in the intensive care unit. The most significant risk factor for an unfavorable outcome is the marker S100 with a cut-off point of 0.2 mcg/l. The results of the analysis indicate the presence of a statistically significant direct relationship between S100>0.2 mcg/l and NSE ≥18.9 ng/ml compared to other variables, while the chance ratio (OR) is 11.9 (95%CI:3.2927-1.6693;). With an increase in blood sugar above 7.4 mmol/l, the OR is 3.82 (95% CI: 2.1289- 0.5539;); with a Glasgow scale below 13 points, the OR is 3.69 (95% CI: 2.1316-0.4819;); with an increase in pCO2 <43.5 mm Hg, the OR was 3.15 (95% CI: 1.8916- 0.4062;). The measure of certainty of the obtained model according to the criterion of pseudo R2 Nagelkerke is 263.5, which corresponds to the excellent quality of the predictive ability of the mathematical model. The developed prognostic model, including the dependent variable S100 and independent variables as predictors of a poor outcome of NSE, pCO2, GCS and Hb, reached a cut-off point of 84.51%, AUC - 0.88 with high levels of sensitivity and specificity: 91.89% and 64.14%, respectively. This model can be used to predict the outcome in patients with acute cerebral pathology.