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58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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S 100 and NSE as biochemical markers in patients with severe injury to the CNS

S 100 und NSE als biochemische Marker bei Patienten mit schweren Verletzungen des ZNS

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  • corresponding author F.J. Hans - Neurochirurgische Klinik der RWTH Aachen
  • S. Giese - Neurochirurgische Klinik der RWTH Aachen
  • E. Yagmur - Institut für Klinische Chemie und Pathobiochemie der RWTH Aachen
  • M. Reinges - Neurochirurgische Klinik der RWTH Aachen
  • J. Gilsbach - Neurochirurgische Klinik der RWTH Aachen
  • E. Uhl - Neurochirurgische Klinik, Klinikum Großhadern, LMU, München

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 050

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc305.shtml

Published: April 11, 2007

© 2007 Hans et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Aim of our study was to analyse two biochemical markers of brain damage, S100 and neuron specific enolase (NSE) in patients with severe injury to the central nervours system (CNS) and their predictive value with regard to short- and long-term outcome.

Methods: In a prospective study 108 consecutively treated patients (2001-2004) with severe injury to the CNS were included after informed consent was obtained. Clinical outcome was rated at discharge, and at 3 and 6 months follow-up using the Glasgow Outcome Scale (GOS) and the modified Rankin scale (mRs). NSE and S100 were determined on the first day after CNS injury and then every third day thereafter until the patient was discharged from intensive care unit. The prognostic impact of both markers on outcome was tested using logistic regression analysis.

Results: Mean age ± SD of the patients was 58±15 years. There were 58 male and 52 female patients. SAH (32%), traumatic brain injury (37%) and intracerebral hemorrhage (21%) were the leading pathologies. Median follow-up time was 27 weeks. Initial GCS (median) on scene was 10, and 3 on admission to the hospital. 42 patients had died, 24 of them during their hospital stay. Median GOS after 6 months was 3, Rankin scale 5. S100 was elevated above normal on the first day after the incident and then decreased again whereas NSE levels were rather inconsistent and did not show any correlation to the outcome. In contrast, increased S 100 levels were correlated with an unfavourable outcome with regard to GOS and mRs at 3 (rGOS3=-0,51, p<0.01; rmRs3=-0,53, p<0.001) and somewhat weaker at 6 months follow-up (rGOS6=-0,47 p<0.001; rmRs6=-0,52, p<0.001). There was no significant difference in NSE and S100 levels between subarachnoid hemorrhage, traumatic brain injury and intracerebral hemorrhage.

Conclusions: Whereas NSE seems to have no predictive value at all increased S100 levels correlate with an unfavourable outcome with regard to GOS and the Rankin Scale. The correlation, however, is not strong enough, that the marker could be used as a single definitive prognostic factor in patients with severe CNS injury.