Significance and Diagnostic Accuracy of Early S100B Serum Concentration after Aneurysmal Subarachnoid Hemorrhage
Abstract
:1. Introduction
2. Experimental Section
2.1. Participants
2.2. Outcome
2.3. Clinical Evaluation
2.4. Clinical Management
2.5. S100B Measurements
2.6. Statistical Analysis
3. Results
3.1. Population
3.2. Serum S100B Concentration Changes
3.3. Accuracy of Serum S100B Concentration to Predict an M-GCS < 6 on Day 3
3.4. Serum S100B Concentration and mRS at ICU Discharge
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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All (n = 81) | EBI-Mild (n = 53) | EBI-Moderate (n = 16) | EBI-Severe (n = 12) | p-Value | |
---|---|---|---|---|---|
Demographic data | |||||
Median age, years (IQR) | 55 (46–63) | 52 (45–60) * | 58 (49–65) | 61 (57–72) | 0.018 |
Sex, male, n (%) | 29 (36%) | 23 (43%) | 4 (25%) | 2 (17%) | 0.141 |
Median SAPSS, (IQR) | 25 (19–39) | 22 (17–27) *** | 41 (28–54) ¥¥¥ | 58 (39–71) | <0.001 |
Aneurysm characteristics | |||||
Median size, mm (IQR) | 4.8 (3.5–7.7) | 4.7 (3.6–7.6) | 4.5 (3.3–8.8) | 4.8 (4–6.7) | 0.987 |
Location, n (%) | |||||
anterior circulation (ACA, ACoA, AChA, pericalosal) | 29 (36%) | 21 (40%) | 2 (13%) | 6 (50%) | 0.094 |
posterior circulation (PCA, PCoA) | 8 (10%) | 5 (9%) | 2 (13%) | 1 (8%) | 0.851 |
MCA | 21 (26%) | 14 (26%) | 5 (31%) | 2 (17%) | 0.588 |
carotid | 5 (6%) | 4 (8%) | 1 (6%) | 0 | 1 |
vertebrobasilary | 14 (17%) | 8 (15%) | 4 (25%) | 2 (17%) | 0.496 |
Hydrocephalus, n (%) | 30 (37%) | 11 (21%) | 12 (75%) ¥¥¥ | 7 (58%) | <0.001 |
Sedation at admission, n (%) | 23 (28%) | 2 (4%) *** | 12 (75%) ¥¥¥ | 9 (75%) | <0.001 |
Re-bleeding, n (%) | 4 (5%) | 0 ** | 1 (6%) | 3 (25%) | 0.003 |
Aneurysm treatment, number of coiling, n (%) | 68 (84%) | 47 (89%) | 13 (81%) | 8 (67%) | 0.134 |
Median time from admission to treatment, h (IQR) | 14 (5–21) | 14 (8–20) | 14 (3–21) | 43 (15–68) | 0.150 |
Aneurysm treatment complication, n (%) | 15 (19%) | 8 (15%) | 5 (31%) | 2 (17%) | 0.259 |
WFNS at first physician contact, n (%) | |||||
1–2 | 55 (68%) | 46 (87%) ** | 5 (31%) ¥¥¥ | 4 (33%) | <0.001 |
3–5 | 26 (32%) | 7 (13%) ** | 11 (69%) ¥¥¥ | 8 (67%) | <0.001 |
Fisher grade, n (%) | |||||
1–2 | 8 (10%) | 8 (15%) | 0 | 0 | 0.158 |
3–4 | 73 (90%) | 45 (85%) | 16 (100%) | 12 (100%) | 0.158 |
Median Hijdra score (IQR) | 18 (12.5–21.5) | 15 (10–19.5) ** | 20 (19;22.5) ¥ | 20.5 (18.5;23) | <0.001 |
SEBES > 2, n (%) | 64 (79%) | 39 (73.6%) | 14 (87.5%) | 11 (91.7%) | 0.305 |
ICH, n (%) | 17 (21%) | 8 (15.1%) | 4 (25%) | 5 (41.7%) | 0.107 |
Median GCS at ICU admission, (IQR) | 14 (3–15) | 15 (14–15) | 3 (3–4) | 3 (3–6) | <0.001 |
DCI occurrence, n (%) | 20 (25%) | 10 (19%) | 7 (44%) | 3 (25%) | 0.116 |
Median mRS at ICU discharge (IQR) | 3 (1–4) | 2 (1–3)*** | 3 (3–4) *, ¥ | 5 (5–6) | <0.001 |
Median length of ICU stay, days (IQR) | 11 (9–16) | 10 (9–13) | 16 (13–18) ¥¥ | 11 (4–18) | 0.012 |
All Patients (n = 81, M-GCS < 6 at Day 3 n = 12) | Patients with M-GCS < 6 at Admission (n = 25, M-GCS < 6 at Day 3 n = 9) | |||
---|---|---|---|---|
S100B Max | GCS at Admission | S100B Max | GCS at Admission | |
AUC, % (95% CI) | 86.7 (73.6;95.9) | 84.1 (73.9–92.6) | 88.2 (72.2;100) | 62.5 (53.1;72.0) |
Best threshold (95% CI) | 0.165 µg/L (0.100;0.494) | 4.5 (4.5–14.5) | 0.336 µg/L (0.123;0.951) | 4.5 (4.5;8.5) |
Se, % (95% CI) | 83.3 (58.3;100) | 75.0 (50;100) | 77.7 (44.4;100) | 100 |
Sp, % (95% CI) | 73.9 (62.3;84.1) | 82.6 (73.9;91.3) | 93.8 (81.3;100) | 25 (6.3;43.8) |
PLR (95% CI) | 3.2 (2.0;5.1) | 4.3 (2.3;7.9) | 12.4 (1.8;85.7) | 1.3 (0.9–1.8) |
NLR (95% CI) | 0.23 (0.06;0.81) | 0.30 (0.11;0.81) | 0.24 (0.07;0.81) | 0.19 (0.01;3.14) |
Gray zone µg/L | 0.104–0.256 | 13.5–4.5 | 0.144–0.336 | 4.5–3 |
Inter-LHR | 0.16–5.75 | 0.25–4.32 | 0.22–12.4 | 1.2–0.19 |
% in gray zone | 38 | 14 | 32 | 84 |
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Balança, B.; Ritzenthaler, T.; Gobert, F.; Richet, C.; Bodonian, C.; Carrillon, R.; Terrier, A.; Desmurs, L.; Perret-Liaudet, A.; Dailler, F. Significance and Diagnostic Accuracy of Early S100B Serum Concentration after Aneurysmal Subarachnoid Hemorrhage. J. Clin. Med. 2020, 9, 1746. https://doi.org/10.3390/jcm9061746
Balança B, Ritzenthaler T, Gobert F, Richet C, Bodonian C, Carrillon R, Terrier A, Desmurs L, Perret-Liaudet A, Dailler F. Significance and Diagnostic Accuracy of Early S100B Serum Concentration after Aneurysmal Subarachnoid Hemorrhage. Journal of Clinical Medicine. 2020; 9(6):1746. https://doi.org/10.3390/jcm9061746
Chicago/Turabian StyleBalança, Baptiste, Thomas Ritzenthaler, Florent Gobert, Caroline Richet, Carole Bodonian, Romain Carrillon, Anne Terrier, Laurent Desmurs, Armand Perret-Liaudet, and Frédéric Dailler. 2020. "Significance and Diagnostic Accuracy of Early S100B Serum Concentration after Aneurysmal Subarachnoid Hemorrhage" Journal of Clinical Medicine 9, no. 6: 1746. https://doi.org/10.3390/jcm9061746
APA StyleBalança, B., Ritzenthaler, T., Gobert, F., Richet, C., Bodonian, C., Carrillon, R., Terrier, A., Desmurs, L., Perret-Liaudet, A., & Dailler, F. (2020). Significance and Diagnostic Accuracy of Early S100B Serum Concentration after Aneurysmal Subarachnoid Hemorrhage. Journal of Clinical Medicine, 9(6), 1746. https://doi.org/10.3390/jcm9061746