Prognostic Value of Early S100 Calcium Binding Protein B and Neuron-Specific Enolase in Patients with Poor-Grade Aneurysmal Subarachnoid Hemorrhage: A Pilot Study.
World Neurosurg
; 108: 669-675, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-28943424
ABSTRACT
BACKGROUND:
This prospective study was undertaken to investigate the value of early S100 calcium binding protein B (S100B) and neuron-specific enolase (NSE) in prognosticating outcome in patients with poor-grade aneurysmal subarachnoid hemorrhage and to develop a statistical model and cutoff values for clinical practice.METHODS:
Between 2012 and 2014, patients with poor-grade subarachnoid hemorrhage (Hunt and Hess grade 3-5) who were admitted within 24 hours after hemorrhage were prospectively enrolled. Serum NSE and S100B levels were assayed once daily during the first 3 days after hemorrhage. Patient characteristics, Glasgow Coma Scale score, Hunt and Hess grade, and Fisher grade at admission were recorded. Glasgow Outcome Scale (GOS) score was obtained at 6 months and dichotomized as poor (score 1-3) or good (score 4-5). Logistic regression and receiver operating characteristic curve were used to assess the value of S100B and NSE in predicting outcome, and cutoff values were calculated using conditional interference trees.RESULTS:
The study included 52 patients. Hunt and Hess grade was 3 in 23 patients, 4 in 15 patients, and 5 in 14 patients. S100B range was 0.07-5.62 µg/L (mean 0.87 µg/L ± 1.06). NSE range was 5.7-94.2 µg/L (mean 16.1 µg/L ± 10.5). At 6-month follow-up, 23 patients (44.2%) had a poor outcome, and 29 patients (55.8%) had a good outcome. Both S100B at day 1 (P = 0.004; cutoff 0.202 µg/L) and NSE at day 1 (P = 0.047; cutoff 9.4 µg/L) predicted good outcome with a specificity of 100%. The specificity of mean S100B in detecting patients with poor outcome reached 100% (P = 0.003) when combined with mean NSE levels.CONCLUSIONS:
S100B and NSE measured during the first 3 days after hemorrhage showed, separately and combined, a significant predictive value in prognosticating clinical outcome in patients with poor-grade subarachnoid hemorrhage. A multicenter study with a large patient cohort is necessary to validate the above-mentioned cutoff values for clinical practice.Palavras-chave
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fosfopiruvato Hidratase
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Hemorragia Subaracnóidea
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Proteínas S100
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Aneurisma Intracraniano
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article