Abstract:
CONTEXT:The usefulness of S100B has been noted as a biomarker in the management of mild traumatic brain injury (mTBI) in adults. However, S100B efficacy as a biomarker in children has previously been relatively unclear. OBJECTIVE:A meta-analysis is conducted to assess the prognostic value of S100B in predicting intracerebral lesions in children after mTBI. DATA SOURCES:Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, and Google Scholar. STUDY SELECTION:Studies including children suffering mTBI who underwent S100B measurement and computed tomography (CT) scans were included. DATA EXTRACTION:Of 1030 articles screened, 8 studies met the inclusion criteria. RESULTS:The overall pooled sensitivity and specificity were 100% (95% confidence interval [CI]: 98%-100%) and 34% (95% CI: 30%-38%), respectively. A second analysis was based on the collection of 373 individual data points from 4 studies. Sensitivity and specificity results, obtained from reference ranges in children with a sampling time <3 hours posttrauma, were 97% (95% CI: 84.2%-99.9%) and 37.5% (95% CI: 28.8%-46.8%), respectively. Only 1 child had a low S100B level and a positive CT scan result without clinically important traumatic brain injury. LIMITATIONS:Only patients undergoing both a CT scan and S100B testing were selected for evaluation. CONCLUSIONS:S100B serum analysis as a part of the clinical routine could significantly reduce the number of CT scans performed on children with mTBI. Sampling should take place within 3 hours of trauma. Cutoff levels should be based on pediatric reference ranges.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Oris C,Pereira B,Durif J,Simon-Pimmel J,Castellani C,Manzano S,Sapin V,Bouvier Ddoi
10.1542/peds.2018-0037subject
Has Abstractpub_date
2018-06-01 00:00:00issue
6eissn
0031-4005issn
1098-4275pii
peds.2018-0037journal_volume
141pub_type
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