Prediction of neuropsychological outcome after mild traumatic brain injury using clinical parameters, serum S100B protein and findings on computed tomography.

PRIMARY OBJECTIVE

To identify if demographics, clinical and computed tomographic (CT) characteristics at first presentation and S100B concentrations at 3 and 6 hours after mild traumatic brain injury (MTBI) predict the development of post-concussion syndrome (PCS) after 1 month.

RESEARCH DESIGN AND METHODS

All consecutive MTBI patients (Glasgow Coma Scale [GCS] score 13-15) admitted to the Emergency Department aged older than 15 were included in this prospective, observational study. Outcome was assessed using a Rivermead Post-Concussion Symptoms Questionnaire to identify the patients with and without PCS 1 month after the injury.

MAIN OUTCOMES AND RESULTS

A total of 176 patients with isolated MTBI were included in the study. After multivariate analysis of the demographics, clinical variables, and CT abnormalities, headache (OR = 2.09, 95% CI = 1.04-4.21, p = 0.038), seizure (OR = 5.64, 95% CI = 1.55-20.54, p = 0.009), the presence of subarachnoid haemorrhage on CT (OR = 3.67, 95% CI = 1.46-9.24, p = 0.006) and 6-hour S100B concentration (OR = 2.22, 95% CI = 1.15-4.28, p = 0.017) were independently significant predictors of the outcome.

CONCLUSIONS

Outcome prediction using baseline characteristics (post-traumatic headache and seizure), CT and laboratory findings (6-hour S100B) were valuable factors for identification of the individual MTBI patient at risk for developing PCS 1 month after the injury.