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Features of urine S100B and its ability to rule out intracranial hemorrhage in patients with head trauma : a prospective trial

Vedin, Tomas LU ; Karlsson, Mathias ; Edelhamre, Marcus LU ; Bergenheim, Mikael and Larsson, Per Anders LU (2019) In European Journal of Trauma and Emergency Surgery
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.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
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
publisher
Urban & Vogel
external identifiers
  • pmid:31388712
  • scopus:85070193394
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
2020-07-08 05:02:11
@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},
  language     = {eng},
  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},
  year         = {2019},
}