The utility of S100B level in detecting mild traumatic brain injury in intoxicated patients
S100B is a serum protein known to elevate in patients with brain injury, but it is unknown whether it can predict intracranial pathology in intoxicated patients following mild traumatic brain injury (MTBI). We performed a systematic review and meta-analysis of the English language literature to addr...
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| Veröffentlicht in: | The American journal of emergency medicine 2020-04, Vol.38 (4), p.799-805 |
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| container_title | The American journal of emergency medicine |
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| creator | Rahimian, Shoja Potteiger, Shawn Loynd, Richard Mercogliano, Christopher Sigal, Adam Short, Alex Donato, Anthony |
| description | S100B is a serum protein known to elevate in patients with brain injury, but it is unknown whether it can predict intracranial pathology in intoxicated patients following mild traumatic brain injury (MTBI). We performed a systematic review and meta-analysis of the English language literature to address this question.
Four prospective cohort trials of serum S100B levels on acutely intoxicated patients with MTBI were included in this meta-analysis. Prevalence of intracranial pathology in the pooled cohort of the intoxicated MTBI patients was 10%, lower than the 15–30% reported in the literature for the general MTBI population. Standard mean difference of serum S100B levels between patients with and without intracranial pathology on CT was 0.73 μg/L (Z = 18.33, P |
| doi_str_mv | 10.1016/j.ajem.2019.12.004 |
| format | Article |
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Four prospective cohort trials of serum S100B levels on acutely intoxicated patients with MTBI were included in this meta-analysis. Prevalence of intracranial pathology in the pooled cohort of the intoxicated MTBI patients was 10%, lower than the 15–30% reported in the literature for the general MTBI population. Standard mean difference of serum S100B levels between patients with and without intracranial pathology on CT was 0.73 μg/L (Z = 18.33, P < 0.001). Following sensitivity analysis and hierarchical summary receiver-operating characteristic models, three remaining articles were used for pooled estimates that found that S100B had a sensitivity of 0.96 (95% CI: 0.84–1.00, I2 = 0%) and specificity of 0.63 (95% CI: 0.58–0.68, I2 = 86.8%) with a high negative predictive value (100%, 95% CI: 95.14–100, I2 = 0%) and a negative LR of 0.06 (95% CI: 0.01–0.31).
Serum S100B levels may have utility in ruling out intracranial pathology in intoxicated patients, however more study and comparison with other serum biomarkers of brain injury are necessary before this becomes the accepted standard of care.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2019.12.004</identifier><identifier>PMID: 31884023</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Bias ; Biomarkers ; Clinical trials ; Emergency medical care ; Intoxicated ; Medical imaging ; Mild traumatic brain injury ; Pathology ; S100B ; S100b protein ; Sensitivity analysis ; Traumatic brain injury</subject><ispartof>The American journal of emergency medicine, 2020-04, Vol.38 (4), p.799-805</ispartof><rights>2018</rights><rights>Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Apr 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-1a7dd8b996415dc71baf9870097aef89a5c240597ae820b741ae94bd30d389df3</citedby><cites>FETCH-LOGICAL-c384t-1a7dd8b996415dc71baf9870097aef89a5c240597ae820b741ae94bd30d389df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2417039090?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27922,27923,45993,64383,64385,64387,72239</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31884023$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rahimian, Shoja</creatorcontrib><creatorcontrib>Potteiger, Shawn</creatorcontrib><creatorcontrib>Loynd, Richard</creatorcontrib><creatorcontrib>Mercogliano, Christopher</creatorcontrib><creatorcontrib>Sigal, Adam</creatorcontrib><creatorcontrib>Short, Alex</creatorcontrib><creatorcontrib>Donato, Anthony</creatorcontrib><title>The utility of S100B level in detecting mild traumatic brain injury in intoxicated patients</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>S100B is a serum protein known to elevate in patients with brain injury, but it is unknown whether it can predict intracranial pathology in intoxicated patients following mild traumatic brain injury (MTBI). We performed a systematic review and meta-analysis of the English language literature to address this question.
Four prospective cohort trials of serum S100B levels on acutely intoxicated patients with MTBI were included in this meta-analysis. Prevalence of intracranial pathology in the pooled cohort of the intoxicated MTBI patients was 10%, lower than the 15–30% reported in the literature for the general MTBI population. Standard mean difference of serum S100B levels between patients with and without intracranial pathology on CT was 0.73 μg/L (Z = 18.33, P < 0.001). Following sensitivity analysis and hierarchical summary receiver-operating characteristic models, three remaining articles were used for pooled estimates that found that S100B had a sensitivity of 0.96 (95% CI: 0.84–1.00, I2 = 0%) and specificity of 0.63 (95% CI: 0.58–0.68, I2 = 86.8%) with a high negative predictive value (100%, 95% CI: 95.14–100, I2 = 0%) and a negative LR of 0.06 (95% CI: 0.01–0.31).
Serum S100B levels may have utility in ruling out intracranial pathology in intoxicated patients, however more study and comparison with other serum biomarkers of brain injury are necessary before this becomes the accepted standard of care.</description><subject>Bias</subject><subject>Biomarkers</subject><subject>Clinical trials</subject><subject>Emergency medical care</subject><subject>Intoxicated</subject><subject>Medical imaging</subject><subject>Mild traumatic brain injury</subject><subject>Pathology</subject><subject>S100B</subject><subject>S100b protein</subject><subject>Sensitivity analysis</subject><subject>Traumatic brain injury</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kE2LFDEQhoMo7rj6BzxIwIuXbquS9CQBL7r4BQseXE8eQjpJa5r-GJP04vx7M87qwYOnqqKeeikeQp4itAi4fzm2dgxzywB1i6wFEPfIDjvOGoUS75MdSN41e9nJC_Io5xEAUXTiIbngqJQAxnfk6833QLcSp1iOdB3oZwR4Q6dwGyYaF-pDCa7E5Rud4-RpSXabbYmO9snWdVzGLR3p766sP6OzJXh6qERYSn5MHgx2yuHJXb0kX969vbn60Fx_ev_x6vV147gSpUErvVe91nuBnXcSeztoJQG0tGFQ2naOCehOk2LQS4E2aNF7Dp4r7Qd-SV6ccw9p_bGFXMwcswvTZJewbtkwzlFwQLGv6PN_0HHd0lK_M0ygBK5BQ6XYmXJpzTmFwRxSnG06GgRzUm9Gc1JvTuoNMlPV16Nnd9FbPwf_9-SP6wq8OgOhuriNIZnsqicXfExVsvFr_F_-Lytxk64</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Rahimian, Shoja</creator><creator>Potteiger, Shawn</creator><creator>Loynd, Richard</creator><creator>Mercogliano, Christopher</creator><creator>Sigal, Adam</creator><creator>Short, Alex</creator><creator>Donato, Anthony</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20200401</creationdate><title>The utility of S100B level in detecting mild traumatic brain injury in intoxicated patients</title><author>Rahimian, Shoja ; Potteiger, Shawn ; Loynd, Richard ; Mercogliano, Christopher ; Sigal, Adam ; Short, Alex ; Donato, Anthony</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-1a7dd8b996415dc71baf9870097aef89a5c240597ae820b741ae94bd30d389df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bias</topic><topic>Biomarkers</topic><topic>Clinical trials</topic><topic>Emergency medical care</topic><topic>Intoxicated</topic><topic>Medical imaging</topic><topic>Mild traumatic brain injury</topic><topic>Pathology</topic><topic>S100B</topic><topic>S100b protein</topic><topic>Sensitivity analysis</topic><topic>Traumatic brain injury</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rahimian, Shoja</creatorcontrib><creatorcontrib>Potteiger, Shawn</creatorcontrib><creatorcontrib>Loynd, Richard</creatorcontrib><creatorcontrib>Mercogliano, Christopher</creatorcontrib><creatorcontrib>Sigal, Adam</creatorcontrib><creatorcontrib>Short, Alex</creatorcontrib><creatorcontrib>Donato, Anthony</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rahimian, Shoja</au><au>Potteiger, Shawn</au><au>Loynd, Richard</au><au>Mercogliano, Christopher</au><au>Sigal, Adam</au><au>Short, Alex</au><au>Donato, Anthony</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The utility of S100B level in detecting mild traumatic brain injury in intoxicated patients</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>38</volume><issue>4</issue><spage>799</spage><epage>805</epage><pages>799-805</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>S100B is a serum protein known to elevate in patients with brain injury, but it is unknown whether it can predict intracranial pathology in intoxicated patients following mild traumatic brain injury (MTBI). We performed a systematic review and meta-analysis of the English language literature to address this question.
Four prospective cohort trials of serum S100B levels on acutely intoxicated patients with MTBI were included in this meta-analysis. Prevalence of intracranial pathology in the pooled cohort of the intoxicated MTBI patients was 10%, lower than the 15–30% reported in the literature for the general MTBI population. Standard mean difference of serum S100B levels between patients with and without intracranial pathology on CT was 0.73 μg/L (Z = 18.33, P < 0.001). Following sensitivity analysis and hierarchical summary receiver-operating characteristic models, three remaining articles were used for pooled estimates that found that S100B had a sensitivity of 0.96 (95% CI: 0.84–1.00, I2 = 0%) and specificity of 0.63 (95% CI: 0.58–0.68, I2 = 86.8%) with a high negative predictive value (100%, 95% CI: 95.14–100, I2 = 0%) and a negative LR of 0.06 (95% CI: 0.01–0.31).
Serum S100B levels may have utility in ruling out intracranial pathology in intoxicated patients, however more study and comparison with other serum biomarkers of brain injury are necessary before this becomes the accepted standard of care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31884023</pmid><doi>10.1016/j.ajem.2019.12.004</doi><tpages>7</tpages></addata></record> |
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| source | ScienceDirect Journals (5 years ago - present); ProQuest Central UK/Ireland |
| subjects | Bias Biomarkers Clinical trials Emergency medical care Intoxicated Medical imaging Mild traumatic brain injury Pathology S100B S100b protein Sensitivity analysis Traumatic brain injury |
| title | The utility of S100B level in detecting mild traumatic brain injury in intoxicated patients |
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