Title:The diagnostic accuracy of serum and urinary S100B protein in children and adolescents with mild traumatic brain injury

Author:Javad Mosafari, Mohammad Ali Fahimi, Kourosh Mohammadi, Hassan Barzegari, Mohammad Ghasem Hanafi and Amal Saki-Malehi

Abstract:Objective: To determine the role of S100B as a serum and urinary biomarker in children with mild traumatic brain injury.
Methods: A cross-sectional study in children and adolescents (6 months to 18 years) with mild traumatic brain injury who were referred to the Emergency Department of Golestan Hospital, Ahvaz City, Iran. The patients were divided into two groups after a brain CT-scan: Group A with positive pathological findings and Group B with a normal brain CT scan. Serum and urinary levels of S100B biomarker were compared between the two groups. Results: A total of 40 children and adolescents were evaluated in patient Groups A and B (20 in each group). The area under the ROC curve was 0.998 (P <0.0001) which indicated a high precision level of serum S100b in the differentiation between the two groups, the best cut-off point was 172.15 ng/l with 95% sensitivity and 100% specificity. In addition, the area under ROC curve of 0.985 (P <0.0001) indicated a high accuracy for S100B urinary concentrations to differentiate between the two groups, the best-obtained cut-off point was 67.75 with a sensitivity and specificity of 90% and 95 % respectively.
Conclusion: The results of this study demonstrated that use of serum and urinary levels of the S100B biomarker can reduce unnecessary brain CT scans in children and adolescents with mild traumatic brain injury. Considering the non-invasiveness of the urinary sample collection, this method can be used in an emergency instead of serum.
Key words: brain injury, biomarkers, S100B protein, diagnosis, emergency service.
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