Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild traumatic brain injury: a prospective observational multicenter cohort study – “the PreTBI I study”

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Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild traumatic brain injury : a prospective observational multicenter cohort study – “the PreTBI I study”. / Seidenfaden, Sophie Charlott; Kjerulff, Julie Linding; Juul, Niels et al.

In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol. 29, 75, 12.2021.

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Seidenfaden SC, Kjerulff JL, Juul N, Kirkegaard H, Møller MF, Münster AMB et al. Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild traumatic brain injury: a prospective observational multicenter cohort study – “the PreTBI I study”. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2021 Dec;29:75. doi: 10.1186/s13049-021-00891-5

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@article{82827da1cd6e45149dd559a1e707ddfc,
title = "Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild traumatic brain injury: a prospective observational multicenter cohort study – “the PreTBI I study”",
abstract = "Background: The biomarker serum S100 calcium-binding protein B (S100B) is used in in-hospital triage of adults with mild traumatic brain injury to rule out intracranial lesions. The biomarker glial fibrillary acidic protein (GFAP) is suggested as a potential diagnostic biomarker for traumatic brain injury. The aim of this study was to investigate the diagnostic accuracy of early prehospital S100B and GFAP measurements to rule out intracranial lesions in adult patients with mild traumatic brain injury. Methods: Prehospital and in-hospital blood samples were drawn from 566 adult patients with mild traumatic brain injury (Glasgow Coma Scale Score 14–15). The index test was S100B and GFAP concentrations. The reference standard was endpoint adjudication of the traumatic intracranial lesion based on medical records. The primary outcome was prehospital sensitivity of S100B in relation to the traumatic intracranial lesion. Results: Traumatic intracranial lesions were found in 32/566 (5.6%) patients. The sensitivity of S100B > 0.10 μg/L was 100% (95%CI: 89.1;100.0) in prehospital samples and 100% (95% CI 89.1;100.0) in in-hospital samples. The specificity was 15.4% (95%CI: 12.4;18.7) in prehospital samples and 31.5% (27.5;35.6) in in-hospital samples. GFAP was only detected in less than 2% of cases with the assay used. Conclusion: Early prehospital and in-hospital S100B levels < 0.10 μg/L safely rules out traumatic intracranial lesions in adult patients with mild traumatic brain injury, but specificity is lower with early prehospital sampling than with in-hospital sampling. The very limited cases with values detectable with our assay do not allow conclusions to be draw regarding the diagnostic accuracy of GFAP. Trial registration: ClinicalTrials.gov identifier: NCT02867137.",
keywords = "Biomarker, Diagnostic accuracy, Emergency medical service, GFAP, Prehospital triage, S100B, Traumatic brain injury",
author = "Seidenfaden, {Sophie Charlott} and Kjerulff, {Julie Linding} and Niels Juul and Hans Kirkegaard and M{\o}ller, {Mette Fogh} and M{\"u}nster, {Anna Marie Bloch} and B{\o}tker, {Morten Thingemann}",
note = "Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = dec,
doi = "10.1186/s13049-021-00891-5",
language = "English",
volume = "29",
journal = "Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine",
issn = "1757-7241",
publisher = "BioMed Central",

}

RIS

TY - JOUR

T1 - Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild traumatic brain injury

T2 - a prospective observational multicenter cohort study – “the PreTBI I study”

AU - Seidenfaden, Sophie Charlott

AU - Kjerulff, Julie Linding

AU - Juul, Niels

AU - Kirkegaard, Hans

AU - Møller, Mette Fogh

AU - Münster, Anna Marie Bloch

AU - Bøtker, Morten Thingemann

N1 - Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/12

Y1 - 2021/12

N2 - Background: The biomarker serum S100 calcium-binding protein B (S100B) is used in in-hospital triage of adults with mild traumatic brain injury to rule out intracranial lesions. The biomarker glial fibrillary acidic protein (GFAP) is suggested as a potential diagnostic biomarker for traumatic brain injury. The aim of this study was to investigate the diagnostic accuracy of early prehospital S100B and GFAP measurements to rule out intracranial lesions in adult patients with mild traumatic brain injury. Methods: Prehospital and in-hospital blood samples were drawn from 566 adult patients with mild traumatic brain injury (Glasgow Coma Scale Score 14–15). The index test was S100B and GFAP concentrations. The reference standard was endpoint adjudication of the traumatic intracranial lesion based on medical records. The primary outcome was prehospital sensitivity of S100B in relation to the traumatic intracranial lesion. Results: Traumatic intracranial lesions were found in 32/566 (5.6%) patients. The sensitivity of S100B > 0.10 μg/L was 100% (95%CI: 89.1;100.0) in prehospital samples and 100% (95% CI 89.1;100.0) in in-hospital samples. The specificity was 15.4% (95%CI: 12.4;18.7) in prehospital samples and 31.5% (27.5;35.6) in in-hospital samples. GFAP was only detected in less than 2% of cases with the assay used. Conclusion: Early prehospital and in-hospital S100B levels < 0.10 μg/L safely rules out traumatic intracranial lesions in adult patients with mild traumatic brain injury, but specificity is lower with early prehospital sampling than with in-hospital sampling. The very limited cases with values detectable with our assay do not allow conclusions to be draw regarding the diagnostic accuracy of GFAP. Trial registration: ClinicalTrials.gov identifier: NCT02867137.

AB - Background: The biomarker serum S100 calcium-binding protein B (S100B) is used in in-hospital triage of adults with mild traumatic brain injury to rule out intracranial lesions. The biomarker glial fibrillary acidic protein (GFAP) is suggested as a potential diagnostic biomarker for traumatic brain injury. The aim of this study was to investigate the diagnostic accuracy of early prehospital S100B and GFAP measurements to rule out intracranial lesions in adult patients with mild traumatic brain injury. Methods: Prehospital and in-hospital blood samples were drawn from 566 adult patients with mild traumatic brain injury (Glasgow Coma Scale Score 14–15). The index test was S100B and GFAP concentrations. The reference standard was endpoint adjudication of the traumatic intracranial lesion based on medical records. The primary outcome was prehospital sensitivity of S100B in relation to the traumatic intracranial lesion. Results: Traumatic intracranial lesions were found in 32/566 (5.6%) patients. The sensitivity of S100B > 0.10 μg/L was 100% (95%CI: 89.1;100.0) in prehospital samples and 100% (95% CI 89.1;100.0) in in-hospital samples. The specificity was 15.4% (95%CI: 12.4;18.7) in prehospital samples and 31.5% (27.5;35.6) in in-hospital samples. GFAP was only detected in less than 2% of cases with the assay used. Conclusion: Early prehospital and in-hospital S100B levels < 0.10 μg/L safely rules out traumatic intracranial lesions in adult patients with mild traumatic brain injury, but specificity is lower with early prehospital sampling than with in-hospital sampling. The very limited cases with values detectable with our assay do not allow conclusions to be draw regarding the diagnostic accuracy of GFAP. Trial registration: ClinicalTrials.gov identifier: NCT02867137.

KW - Biomarker

KW - Diagnostic accuracy

KW - Emergency medical service

KW - GFAP

KW - Prehospital triage

KW - S100B

KW - Traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=85107228393&partnerID=8YFLogxK

U2 - 10.1186/s13049-021-00891-5

DO - 10.1186/s13049-021-00891-5

M3 - Journal article

C2 - 34078435

AN - SCOPUS:85107228393

VL - 29

JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

SN - 1757-7241

M1 - 75

ER -