Ulrich Linsenmaier MD, Presenter: Nothing to Disclose

Michael Krotz, Abstract Co-Author: Nothing to Disclose

Peter Biberthaler, Abstract Co-Author: Nothing to Disclose

Markus Korner MD, Abstract Co-Author: Nothing to Disclose

Klaus-Jürgen Pfeifer MD, Abstract Co-Author: Nothing to Disclose

Maximilian Reiser PhD, Abstract Co-Author: Nothing to Disclose

Thomas Mussack, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

U.L.,M.K.,P.B.,T.M.: The study was partially funded by ROCHE Diagnostics, Germany

Evaluation of neuroprotein S-100 as serum parameter to triage patients at risk from a large number of patients after MHT that should immediately undergo CCT in order to reduce the large number of normal CCT studies in this group of patients.

In a prospective study 1029 continuous patients after MHT (GCS 13-15) were evaluated for traumatic brain injury (TBI) by CCT, determination of neuroprotein S-100 (Elecsys® S100, Roche Diagnostics) and clinical and neurological findings. All images were evaluated by two independent radiologists for brain injury (CCT+; cerebral bleedings, contusions, fractures) and compared to a cut off value (0.105 µg/L) for S100, a known marker protein for TBI. Controversial findings were read in consensus.

CCT showed pathological findings in 75/1029 (7,9% CCT+) cases, 954/1029 were normal (92.1% CCT-). S100- was elevated in 637/1029 (62% S100+) and normal in 317/1029 (31% S100-). Sensitivity for S100 in detecting traumatic brain injury was 99% (CI95%: 96-100%), specificity 33% (CI95%: 30-36%). The resulting NPV and PPV for S100B were however 99% (CI95%: 99-100%) and 10% (CI95%: 8-13%) respectively.

S100 has a high sensitivity for TBI, however specificity is low. The high NPV allows to exclude patients from CCT when S-100 values are normal. The test has therefore potential to reduce the large number of normal CCT studies after MHT.

Linsenmaier, U, Krotz, M, Biberthaler, P, Korner, M, Pfeifer, K, Reiser, M, Mussack, T, et al, , Efficient Use of CCT after Minor Head Trauma (MHT): Neuroprotein S-100 Can Help to Triage the Patients at Risk for Traumatic Brain Injury.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417898.html