Predictive value of serum S100B levels in patients with multiple trauma combined delirium for their outcome at intensive care unit discharge

Abstract

Objective: To investigate the predictive value of elevated serum S100B level in patients with multiple traumas combined delirium for the clinical prognosis prior to intensive care unit (ICU) discharge. Methods: One hundred seventy-nine patients with multiple traumas diagnosed as delirium after admission over 48 hours to the Department of Critical Care Medicine, People's Hospital Affiliated to Jiangsu University from January 2013 to December 2016 were divided into two groups according to the level of serum S100B measured prior to the ICU discharge: high S100B group (≥0.20 μg/L, n=53) and low S100B group (<0.20 μg/L, n=126). The difference of the clinical prognoses between the two groups was evaluated with t or Chi-square test. Results: The patients in high S100B group had a higher ICU readmission rate (18.9% vs 6.3%, χ(2)=6.464, P=0.011). The 30-day mortality was higher for patients in high S100B group than that in low S100B group (5.7% vs 4.0%, χ(2)=0.308, P=0.579). The incidence of adverse outcome was also significantly higher for patients in high S100B group than that in low S100B group (35.8% vs 17.5%, χ(2)=7.144, P=0.008). The sequential organ failure assessment (SOFA) score before ICU discharge was also higher for patients in the high S100B group than that in the low S100B group (3.2±1.3 vs 2.4±1.1, t=4.204, P=0.000). The duration of ICU stay for patients in high S100B group was significantly longer than that in the low S100B group[(16±8) vs (12±5) d, t=4.095, P=0.000]. The area under the curve (AUC) of receiver operating characteristics of the S100B was 0.742, 95% CI: 0.574-0.910. The multivariate logistic regression analysis revealed that the odds ratio (95% CI) in the prediction of adverse outcomes by S100B level prior to the ICU discharge was 1.39(1.15-1.53), P=0.009. Conclusion: Elevated serum level of S100B in patients with multiple traumas combined delirium prior to ICU discharge is closely associated with poor clinical prognosis, but it is only a modest predictor that may not be used alone in judgements of clinical treatments for patients.