Prognostic properties of the association between the S‑100B protein levels and the mean cerebral blood flow velocity in patients diagnosed with severe traumatic brain injury

Dzierzęcki,Sebastian; Ząbek,Mirosław; Zaczyński,Artur; Tomasiuk,Ryszard

doi:10.3892/br.2022.1541

Prognostic properties of the association between the S‑100B protein levels and the mean cerebral blood flow velocity in patients diagnosed with severe traumatic brain injury

Authors:
- Sebastian Dzierzęcki
- Mirosław Ząbek
- Artur Zaczyński
- Ryszard Tomasiuk
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Affiliations: Department of Neurosurgery, Postgraduate Medical Centre, 03‑242 Warsaw, Poland, Clinical Department of Neurosurgery, Central Clinical Hospital of the Ministry of the Interior and Administration, 02‑507 Warsaw, Poland, Faculty of Medical Sciences and Health Sciences, Kazimierz Pulaski University of Technology and Humanities Radom, 26‑600 Radom, Poland
Published online on: May 19, 2022 https://doi.org/10.3892/br.2022.1541
Article Number: 58
Copyright: © Dzierzęcki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Craniocerebral injury (CBI) is tissue damage caused by a sudden mechanical force. CBI can result in neurological, neuropsychological and psychiatric dysfunctions. Currently, the severity of CBI is assessed using the Glasgow Coma Scale, brain perfusion pressure measurements, transcranial Doppler tests and biochemical markers. This study aimed to determine the applicability of the S‑100B protein levels and the time‑averaged mean maximum cerebral blood flow velocity (V_mean) as a means of predicting the treatment outcomes of CBI in the first 4 days of hospitalization. The results validated the standard reference ranges previously proposed for the concentration of S‑100B (0.05‑0.23 µg/l) and the mean of cerebral blood flow velocity (30.9 to 74.1 cm/sec). The following stratification scheme was used to predict the success of treatment: Patients with a Glasgow Outcome Scale (GOS) score ≥4 or GOS <4 were stratified into ‘favorable’ and ‘unfavorable’ groups, respectively. The favorable group showed relatively constant levels of the S‑100B protein close to the normal range and exhibited an increase in V_mean, but this was still within the normal range. The unfavorable group exhibited a high level of S‑100B protein and increased V_mean outside of the normal ranges. The changes in the levels of S‑100B in the unfavorable and favorable groups were ‑0.03 and ‑0.006 mg/l/h, respectively. Furthermore, the rate of decrease in the V_mean value in the unfavorable and favorable groups were ‑0.26 and ‑0.18 cm/sec/h, respectively. This study showed that constant levels of S‑100B protein, even slightly above the normal range, associated with an increase in V_mean was indicative of a positive therapeutic outcome. However, additional research is required to obtain the appropriate statistical strength required for clinical practice.

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