The prognostic value of serum S-100B protein in spontaneous subarachnoid haemorrhage

G. Stranjalis, S. Korfias, C. Psachoulia, A. Kouyialis, D. E. Sakas, A. D. Mendelow

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Abstract

Background. Despite the major progress in neurophysiological monitoring, there are still difficulties in the early identification and quantification of cerebral damage after a stroke. In this prospective study we examined the associations between serum S-100B protein, a serum marker of brain injury, and initial neurological-neuroimaging severity, secondary deterioration, external ventricular drainage (EVD: therapeutic intervention) and outcome in patients with subarachnoid haemorrhage (SAH). Method. We recorded all pertinent clinical data of 52 patients with SAH and measured S-100B serum levels on admission and every 24 h for a maximum of 9 consecutive days. Mann-Whitney U-test and Kruskal Wallis analysis were employed to assess the association of S-100B levels with all variables of interest. Log-rank test was used to evaluate survival and Cox's proportional hazard regression analysis to define the significant predictors of survival rate. Findings. Admission S-100B was statistically significantly associated with initial neurological status, neuroimaging severity, and one-year outcome (p = 0.0002, 0.001, and 0.017, Kruskal Wallis analysis). Admission S-100B above 0.3 μg/L predicted unfavourable outcome (p < 0.0001, log rank test) and constituted an independent predictor of short-term survival (p = 0.035 Cox's proportional hazard regression analysis) with a hazard ratio of 2.2 (95% C.I.: 1.06-4.6) indicating a more than doubling of death probability. Secondary neurological deterioration associated with S-100B increase (p < 0.0001) and external ventricular drainage (EVD) with S-100B reduction (p = 0.003, Wilcoxon signed rank test). Conclusions. Serum S-100B protein seems to be a useful biochemical indicator of neurological - neuroimaging severity, secondary deterioration, EVD (therapeutic intervention), and outcome in patients with SAH.

Original languageEnglish
Pages (from-to)231-237
Number of pages7
JournalActa Neurochirurgica
Volume149
Issue number3
DOIs
Publication statusPublished - Mar 2007

Keywords

  • Cerebral aneurysm
  • Outcome
  • S-100B protein
  • SAH
  • Spontaneous subarachnoid haemorrhage

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    Stranjalis, G., Korfias, S., Psachoulia, C., Kouyialis, A., Sakas, D. E., & Mendelow, A. D. (2007). The prognostic value of serum S-100B protein in spontaneous subarachnoid haemorrhage. Acta Neurochirurgica, 149(3), 231-237. https://doi.org/10.1007/s00701-006-1106-9