Prognostic Value of Early S100 Calcium Binding Protein B and Neuron-Specific Enolase in Patients with Poor-Grade Aneurysmal Subarachnoid Hemorrhage: A Pilot Study

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...

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Veröffentlicht in:World neurosurgery 2017-12, Vol.108, p.669-675
Hauptverfasser: Abboud, Tammam, Mende, Klaus Christian, Jung, Roman, Czorlich, Patrick, Vettorazzi, Eik, Priefler, Marion, Kluge, Stefan, Westphal, Manfred, Regelsberger, Jan
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container_issue
container_start_page 669
container_title World neurosurgery
container_volume 108
creator Abboud, Tammam
Mende, Klaus Christian
Jung, Roman
Czorlich, Patrick
Vettorazzi, Eik
Priefler, Marion
Kluge, Stefan
Westphal, Manfred
Regelsberger, Jan
description 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. 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. 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. 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.
doi_str_mv 10.1016/j.wneu.2017.09.074
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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. 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). 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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. 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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28943424</pmid><doi>10.1016/j.wneu.2017.09.074</doi><tpages>7</tpages></addata></record>
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subjects Adult
Aged
Aged, 80 and over
Biomarkers - blood
Female
Follow-Up Studies
Glasgow Coma Scale
Glasgow Outcome Scale
Humans
Intracranial aneurysm
Intracranial Aneurysm - blood
Intracranial Aneurysm - therapy
Logistic Models
Male
Middle Aged
NSE
Phosphopyruvate Hydratase - blood
Pilot Projects
Prognosis
Prospective Studies
ROC Curve
S100
S100 Proteins - blood
Subarachnoid hemorrhage
Subarachnoid Hemorrhage - blood
Subarachnoid Hemorrhage - therapy
Time Factors
Treatment Outcome
title Prognostic Value of Early S100 Calcium Binding Protein B and Neuron-Specific Enolase in Patients with Poor-Grade Aneurysmal Subarachnoid Hemorrhage: A Pilot Study
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