Ryb Gabriel E, Dischinger Patricia C, Auman Kimberly M, Kufera Joseph A, Cooper Carnell C, Mackenzie Colin F, Kane Robert L
National Study Center for Trauma and Emergency Medical Systems .
Brain Inj. 2014;28(11):1430-5. doi: 10.3109/02699052.2014.919525. Epub 2014 Jun 9.
To determine the usefulness of S-100β, a marker for central nervous system damage, in the prediction of long-term outcomes after mild traumatic brain injury (MTBI) Hypothesis: Mid- and long-term outcomes of MTBI (i.e. 3, 6 and 12 months post-injury and return-to-work or school (RTWS)) may be predicted based on pre-injury and injury factors as well as S-100β.
MTBI subjects without abnormal brain computed tomography requiring intervention, focal neurological deficits, seizures, amnesia > 24 hours and severe or multiple injuries were recruited at a level I trauma centre. Admission S-100β measurements and baseline Concussion Symptom Checklist were obtained. Symptoms and RTWS were re-assessed at follow-up visits (3-10 days and 3, 6 and 12 months). Outcomes included number of symptoms and RTWS at follow-up. Chi-square tests, linear and logistic regression models were used and p < 0.05 was considered statistically significant.
One hundred and fifty of 180 study subjects had S-100β results. Eleven per cent were unable to RTWS at 12 months. S-100β levels were not associated with post-concussive symptomatology at follow-up. In addition, no association was found between S-100β levels and RTWS.
Amongst MTBI patients, S-100β levels are not associated with prolonged post-concussive syndrome or the inability to RTWS.
确定中枢神经系统损伤标志物S-100β在预测轻度创伤性脑损伤(MTBI)后长期预后中的作用。假设:MTBI的中长期预后(即受伤后3、6和12个月以及重返工作或学校(RTWS)情况)可根据伤前和损伤因素以及S-100β进行预测。
在一级创伤中心招募了无异常脑计算机断层扫描需要干预、无局灶性神经功能缺损、无癫痫发作、失忆时间不超过24小时且无严重或多发伤的MTBI患者。获取入院时S-100β测量值和基线脑震荡症状清单。在随访时(3 - 10天以及3、6和12个月)重新评估症状和RTWS情况。结局包括随访时的症状数量和RTWS情况。采用卡方检验、线性和逻辑回归模型,p < 0.05被认为具有统计学意义。
180名研究对象中有150名获得了S-100β检测结果。11%的患者在12个月时无法重返工作或学校。随访时S-100β水平与脑震荡后症状学无关。此外,未发现S-100β水平与RTWS之间存在关联。
在MTBI患者中,S-100β水平与延长的脑震荡后综合征或无法重返工作或学校无关。