Abstract
Aim: The evaluation of the S100B alterations as a prognostic biomarker of Head Injuries (HI) in childhood. Materials and methods: In this study 74 children (45 boys and 29 girls), 3-14 years old (Average: 7.86 years old) from 1/2017 until 9/2017 involved. 64/74 patients with clear HI and 10/74 witnesses, while no one needed mechanical breathing support or hospitalization in the Emergency Department (ED). Based on the severity of the clinical manifestations they were classified into 4 groups. The determination of the S100B with ECLIA method was carried out in 3, 12, 24 and 48 hours after the HI with cut-off rate the 0.191 μg/L. 64/74 patients were submitted to neuroimaging via head and brain CTs, 6-8 hours after the injury. Results: Though the statistical processing of the results it was ascertained 100% sensitivity, 96.16% specialization, 85.71 positive prognostic value and 100% negative prognostic value of S100B. Conclusions: The early determination of S100B during the initial evaluation of a child with HI can constitute a diagnostic test for the possibility of a coexisting intracranial complication; S100B if applied on a regular basis, can constitute as a detection testing in children who are submitted to the ED due to HI; Calculation of S100B before discharged from the hospital, could be served as an indicator of the improving clinical condition.
Highlights
The early determination of S100B during the initial evaluation of a child with Head Injury (HI) can constitute a diagnostic test for the possibility of a coexisting intracranial complication; S100B if applied on a regular basis, can constitute as a detection testing in children who are submitted to the Emergency Department (ED) due to HI; Calculation of S100B before discharged from the hospital, could be served as an indicator of the improving clinical condition
The correspondence of the S100B rates, per survey group with the findings of the neuroimaging is presented in Table 2 while the range of S100B per group is presented in Supplementary Figure 1
The various fluctuations of S100B in 3/9 patients of group B and in 4/40 patients of group C who exhibited subdural hematoma are presented in Supplementary Figures 2 and 3
Summary
The main goal during the treatment of a Head Injury (HI) is the early revelation of a dynamic intracranial complication because the primary trauma will be early diagnosed and the secondary trauma will be avoided, preventing in this way the development of intracranial hypertension, hypoxia, hypercapnia and hypervolemia. In this philosophy there are difficulties concerning the daily clinical activity leading the doctors to actions of defensive medicine, meaning the implementation of numerous clinical laboratory examinations that can be considered to be unnecessary.
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