Features of urine S100B and its ability to rule out intracranial hemorrhage in patients with head trauma : a prospective trial
(2021) In European Journal of Trauma and Emergency Surgery 47(5). p.1467-1475- Abstract
Purpose: Traumatic brain injury causes morbidity and mortality worldwide. S100B is the most documented emergency brain biomarker and its urine-assay might be advantageous because of easier sampling. The primary aim was to evaluate urine S100B’s ability to rule out intracranial hemorrhage. Secondary aims included S100B temporal pattern for 48 h post-trauma and chemical properties of urine that affect urine S100B. Methods: Patients with head trauma were sampled for serum and urine S100B. Patients who were admitted for intracranial hemorrhage were sampled for 48 h to assess S100B-level, renal function, urine-pH, etc. Results: The negative predictive value of serum S100B was 97.0% [95% confidence interval (CI) 89.5–99.2%] and that of urine... (More)
Purpose: Traumatic brain injury causes morbidity and mortality worldwide. S100B is the most documented emergency brain biomarker and its urine-assay might be advantageous because of easier sampling. The primary aim was to evaluate urine S100B’s ability to rule out intracranial hemorrhage. Secondary aims included S100B temporal pattern for 48 h post-trauma and chemical properties of urine that affect urine S100B. Methods: Patients with head trauma were sampled for serum and urine S100B. Patients who were admitted for intracranial hemorrhage were sampled for 48 h to assess S100B-level, renal function, urine-pH, etc. Results: The negative predictive value of serum S100B was 97.0% [95% confidence interval (CI) 89.5–99.2%] and that of urine S100B was 89.1% (95% CI 85.5–91.9%). The specificity of serum S100B was 34.4% (95% CI 27.7–41.6%) and that of urine was 67.1% (95% CI 59.4–74.1%). Urine-pH correlated strongly with urine S100B during the first 6-h post-trauma. Trend-analysis of receiver operator characteristics of S100B in serum, urine the arithmetic difference between serum and urine S100B showed the largest area under the curve for arithmetic difference, which had a negative predictive value of 93.1% (95% CI 89.1–95.8%) and a specificity of 71.8% (95% CI 64.4–78.4%). Conclusion: This study cannot support ruling out intracranial hemorrhage with urine S100B. Urine-pH might affect urine S100B and merits further studies. Serum and urine S100B have poor concordance and interchangeability. The arithmetic difference had a slightly better area under the curve and can be worth exploring in certain subgroups.
(Less)
- author
- Vedin, Tomas LU ; Karlsson, Mathias ; Edelhamre, Marcus LU ; Bergenheim, Mikael and Larsson, Per Anders LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Blood specimen collection, S100 calcium-binding protein beta subunit, Traumatic brain injuries, Urine specimen collection
- in
- European Journal of Trauma and Emergency Surgery
- volume
- 47
- issue
- 5
- pages
- 1467 - 1475
- publisher
- Urban & Vogel
- external identifiers
-
- scopus:85070193394
- pmid:31388712
- ISSN
- 1863-9933
- DOI
- 10.1007/s00068-019-01201-6
- language
- English
- LU publication?
- yes
- id
- a554cf4d-b6cc-467a-95fc-1516f5210b5d
- date added to LUP
- 2019-08-27 09:52:11
- date last changed
- 2024-04-16 17:19:00
@article{a554cf4d-b6cc-467a-95fc-1516f5210b5d,
abstract = {{<p>Purpose: Traumatic brain injury causes morbidity and mortality worldwide. S100B is the most documented emergency brain biomarker and its urine-assay might be advantageous because of easier sampling. The primary aim was to evaluate urine S100B’s ability to rule out intracranial hemorrhage. Secondary aims included S100B temporal pattern for 48 h post-trauma and chemical properties of urine that affect urine S100B. Methods: Patients with head trauma were sampled for serum and urine S100B. Patients who were admitted for intracranial hemorrhage were sampled for 48 h to assess S100B-level, renal function, urine-pH, etc. Results: The negative predictive value of serum S100B was 97.0% [95% confidence interval (CI) 89.5–99.2%] and that of urine S100B was 89.1% (95% CI 85.5–91.9%). The specificity of serum S100B was 34.4% (95% CI 27.7–41.6%) and that of urine was 67.1% (95% CI 59.4–74.1%). Urine-pH correlated strongly with urine S100B during the first 6-h post-trauma. Trend-analysis of receiver operator characteristics of S100B in serum, urine the arithmetic difference between serum and urine S100B showed the largest area under the curve for arithmetic difference, which had a negative predictive value of 93.1% (95% CI 89.1–95.8%) and a specificity of 71.8% (95% CI 64.4–78.4%). Conclusion: This study cannot support ruling out intracranial hemorrhage with urine S100B. Urine-pH might affect urine S100B and merits further studies. Serum and urine S100B have poor concordance and interchangeability. The arithmetic difference had a slightly better area under the curve and can be worth exploring in certain subgroups.</p>}},
author = {{Vedin, Tomas and Karlsson, Mathias and Edelhamre, Marcus and Bergenheim, Mikael and Larsson, Per Anders}},
issn = {{1863-9933}},
keywords = {{Blood specimen collection; S100 calcium-binding protein beta subunit; Traumatic brain injuries; Urine specimen collection}},
language = {{eng}},
number = {{5}},
pages = {{1467--1475}},
publisher = {{Urban & Vogel}},
series = {{European Journal of Trauma and Emergency Surgery}},
title = {{Features of urine S100B and its ability to rule out intracranial hemorrhage in patients with head trauma : a prospective trial}},
url = {{http://dx.doi.org/10.1007/s00068-019-01201-6}},
doi = {{10.1007/s00068-019-01201-6}},
volume = {{47}},
year = {{2021}},
}