| S100B as an additional prognostic marker in subarachnoid aneurysmal hemorrhage. | |
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MedLine Citation:
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PMID: 18596638 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Studies of new neuroprotective approaches in patients with subarachnoid aneurysmal hemorrhage and better family information would benefit from the development of laboratory markers of brain ischemia. The goal of this study was to evaluate mean 15-day S100B for predicting outcomes after subarachnoid aneurysmal hemorrhage. DESIGN: Single center prospective cohort with consecutive inclusions. SETTING: Anesthesiology and Critical Care Neurosurgical Unit of a university hospital. PATIENTS: One hundred nine patients admitted within 48 hrs after subarachnoid aneurysmal hemorrhage onset and treated by surgical clipping or coiling within 48 hrs following admission. INTERVENTIONS: We recorded initial World Federation of Neurologic Surgeons and Fisher grades; comorbidities; initial severity; aneurysm location; presence of acute hydrocephalus; presence of intraventricular hemorrhage; initial seizures and neurogenic lung edema; initial troponin values; treatment of aneurysm; and occurrence of vasospasm. MEASUREMENTS AND MAIN RESULTS: S100B was assayed daily over the first 15 days. Glasgow Outcome Scores were recorded at intensive care unit discharge and after 6 and 12 months. The main outcome criterion was the 12-month Glasgow Outcome Scale score dichotomized as poor (Glasgow Outcome Scale 1-3) or good (Glasgow Outcome Scale 4-5). Seventy percent of patients had good 12-month outcome. Poor outcome was associated with higher initial World Federation of Neurologic Surgeons and Fisher scores, neurogenic lung edema, high mean 15-day S100B but not initial, troponin initial value, intraventricular hemorrhage, angiographically documented vasospasm, all in an univariate manner. After multivariate analysis, only mean 15-day S100B value significantly predicted outcome (p < 0.0005). The best cutoff for the mean 15-day S100B value was 0.23 microg/L (specificity 0.90, 95% confidence interval [CI] 0.81-0.95; sensitivity 0.91, 95% CI 0.75-0.98; area under the curve 0.98, 95% CI 0.87-0.99). CONCLUSION: S100B elevation over the first 15 days after subarachnoid aneurysmal hemorrhage is associated with poor outcome after subarachnoid aneurysmal hemorrhage. This result supports the use of S100B as a surrogate marker for brain ischemia in patients with subarachnoid aneurysmal hemorrhage. |
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Authors:
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Paola Sanchez-Peña; Ana-Rosa Pereira; Nader-Antoine Sourour; Alessandra Biondi; Lise Lejean; Chantal Colonne; Anne-Laure Boch; Mossab Al Hawari; Lamine Abdennour; Louis Puybasset |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 36 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-31 Completed Date: 2008-08-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2267-73 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Teaching Hospital, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie-Paris 6, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers Female Glasgow Outcome Scale Humans Intensive Care Units Male Middle Aged Nerve Growth Factors / blood* Predictive Value of Tests Prognosis S100 Proteins / blood* Severity of Illness Index Subarachnoid Hemorrhage / blood*, classification, therapy Vasospasm, Intracranial / prevention & control |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Nerve Growth Factors; 0/S-100 calcium-binding protein beta subunit; 0/S100 Proteins |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2008 Aug;36(8):2452-3
[PMID:
18664797
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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