Article
Prognostic value of S100B protein and neuron-specific enolase in patients with poor grade aneurysmal subarachnoid haemorrhage
Search Medline for
Authors
Published: | June 9, 2017 |
---|
Outline
Text
Objective: To investigate the value of S100b protein (S100) and neuron-specific enolase (NSE) in prognosticating outcome in patients with high grade aneurysmal subarachnoid haemorrhage (SAH).
Methods: Between 2012- 2014, patients SAH (Hunt & Hess grade 3-5) who were admitted within 24 hours after haemorrhage were prospectively enrolled. Serum NSE and S100 levels were assayed once daily during the first 3 days after haemorrhage. Patient characteristics, Glasgow Coma Scale, Hunt & Hess and Fisher grade at admission were recorded. Glasgow outcome scale was obtained at 6 months and dichotomized as poor (1–3) or good (4–5). Logistic regression and ROC curve were used to assess the predictive value of S100 and NSE and cut-off values were calculated using conditional interference trees.
Results: 52 patients were included. Hunt & Hess grading was 3 in 23 patients, 4 in 15 and 5 in 14 patients. S100 ranged from 0.07 to 5.62µg/l (mean 0.87±1.06µg/l). NSE range was 5.7 to 94.2µg/l (mean of 16.1±10.5µg/l). At 6 months follow-up, 23 patients (44.2%) had poor outcome and 29 (55.8%) showed good outcome. Both S100 at day one (p=0.004, cut-off 0.202µg/l) and NSE at day one (p=0.047, cut-off 9.4µg/l) predicted good outcome with a specificity of 100%. The specificity of mean S100 in predicting poor outcome reached 100% (p=0.003) when combined with mean NSE levels.
Conclusion: S100 and NSE measured during the first 3 days after haemorrhage showed separately and combined a significant predictive value in prognosticating clinical outcome in patients with high grade SAH.