Early and persistent high level of PS 100β is associated with increased poor neurological outcome in patients with SAH: is there a PS 100β threshold for SAH prognosis?

doi:10.1186/s13054-016-1200-1

. 2016 Feb 3;20:33.

doi: 10.1186/s13054-016-1200-1.

Early and persistent high level of PS 100β is associated with increased poor neurological outcome in patients with SAH: is there a PS 100β threshold for SAH prognosis?

Hervé Quintard¹, Sébastien Leduc², Patricia Ferrari³, Isabelle Petit⁴, Carole Ichai^{5

6}

Affiliations

¹ Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. quintard.h@chu-nice.fr.
² Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. leduc.s@chu-nice.fr.
³ Department of Biochemistry, Hôpital Pasteur 1, Nice University Hospital, Nice, 06000, France. panaia-ferrari.p@chu-nice.fr.
⁴ Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. petit.i@chu-nice.fr.
⁵ Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. ichai.c@chu-nice.fr.
⁶ IRCAN, UMR INSERM U10891-CNRS 7284, Faculté de Médecine, Nice Sophia-Antipolis University, Nice University Hospital, Nice, 06000, France. ichai.c@chu-nice.fr.

PMID: 26843206
PMCID: PMC4738799
DOI: 10.1186/s13054-016-1200-1

Free PMC article

Early and persistent high level of PS 100β is associated with increased poor neurological outcome in patients with SAH: is there a PS 100β threshold for SAH prognosis?

Hervé Quintard et al. Crit Care. 2016.

Free PMC article

. 2016 Feb 3;20:33.

doi: 10.1186/s13054-016-1200-1.

Authors

Hervé Quintard¹, Sébastien Leduc², Patricia Ferrari³, Isabelle Petit⁴, Carole Ichai^{5

6}

Affiliations

¹ Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. quintard.h@chu-nice.fr.
² Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. leduc.s@chu-nice.fr.
³ Department of Biochemistry, Hôpital Pasteur 1, Nice University Hospital, Nice, 06000, France. panaia-ferrari.p@chu-nice.fr.
⁴ Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. petit.i@chu-nice.fr.
⁵ Intensive Care Unit, Hôpital Pasteur 2, Nice University Hospital, 30 Voie Romaine, Nice, 06000, France. ichai.c@chu-nice.fr.
⁶ IRCAN, UMR INSERM U10891-CNRS 7284, Faculté de Médecine, Nice Sophia-Antipolis University, Nice University Hospital, Nice, 06000, France. ichai.c@chu-nice.fr.

PMID: 26843206
PMCID: PMC4738799
DOI: 10.1186/s13054-016-1200-1

Abstract

Background: Protein S100β (PS100 β) and neuron specific enolase (NSE) have been described as biological markers of neuronal damage. The purpose of our study was to assess the prognosis thresholds of these biomarkers in subarachnoid aneurysmal hemorrhage (SAH).

Methods: Forty eight patients admitted following SAH were treated by endovascular coiling. Initial neurologic severity was assessed using the World Federation Neurologic Surgeons (WFNS), Fisher grades, initial Glasgow coma scale (GCS) and SAPS II. PS100β and NSE plasma concentration were measured daily within the first week. The primary endpoint of the study was the 6-month Glasgow Outcome Score (GOS) dichotomized as poor (GOS 1-3) or good (GOS 4-5).

Results: A poor outcome at 6-months was associated with significant higher levels of S100β value from day 1 to day 7, whereas NSE values were significantly higher from day 5 to day 7. Best threshold value, for prognosis, was obtained at day 5 for PS100β >0.13 μg/L (specificity 0.95 95% confidence interval (CI) 0.74-1; sensitivity 0.83 95% CI 0.65-0.93) and day 7 for NSE >14.5 μg/L (specificity 0.90 95% CI 0.67-0.98); sensitivity (0.69 95% CI 0.51-0.83)). After multivariate logistic analysis, only PS100β at day 5 and SAPS II enabled to predict neurological outcome at 6 months (p<0.05).

Conclusion: PS100β >0.13 μg/L at day 5 is an independent predicting factor of poor neurological outcome at 6 months following SAH. This result could support the use of this biomarker at the acute phase of SAH to help physician determine the prognosis.

Figures

**Fig. 1**
Time course values of S100β within the first week after subarachnoid hemorrhage in groups with good or poor outcome (*p <0.05). *GOS* Glasgow outcome scale

**Fig. 2**
Time course values of neuron specific enolase NSE within the first week after subarachnoid hemorrhage in the groups with good or poor outcome (*p <0.05). *GOS* Glasgow outcome scale

**Fig. 3**
Receiver operating characteristic curve for 6-month prognosis by PS100β at day 5 (D5) after subarachnoid hemorrhage

**Fig. 4**
Receiver operating characteristic curve for 6-month prognosis by neuron specific enolase (*NSE*) at day 7 (D7) after subarachnoid hemorrhage

See this image and copyright information in PMC

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References

1. Connolly ES, Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012;43(6):1711–37. doi: 10.1161/STR.0b013e3182587839. - DOI - PubMed
1. Teasdale GM, Drake CG, Hunt W, Kassell N, Sano K, Pertuiset B, et al. A universal subarachnoid hemorrhage scale: report of a committee of the World Federation of Neurosurgical Societies. J Neurol Neurosurg Psychiatry. 1988;51(11):1457. doi: 10.1136/jnnp.51.11.1457. - DOI - PMC - PubMed
1. Soehle M, Chatfield DA, Czosnyka M, Kirkpatrick PJ. Predictive value of initial clinical status, intracranial pressure and transcranial Doppler pulsatility after subarachnoid haemorrhage. Acta Neurochir. 2007;149(6):575–83. doi: 10.1007/s00701-007-1149-6. - DOI - PubMed
1. Lindvall P, Runnerstam M, Birgander R, Koskinen LO. The Fisher grading correlated to outcome in patients with subarachnoid haemorrhage. Br J Neurosurg. 2009;23(2):188–92. doi: 10.1080/02688690802710668. - DOI - PubMed
1. Usui A, Kato K, Murase M, Hotta T, Tanaka M, Takeuchi E, et al. Neural tissue-related proteins (NSE, G0 alpha, 28-kDa calbindin-D, S100b and CK-BB) in serum and cerebrospinal fluid after cardiac arrest. J Neurol Sci. 1994;123(1–2):134–9. doi: 10.1016/0022-510X(94)90215-1. - DOI - PubMed

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[1] Connolly ES, Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012;43(6):1711–37. doi: 10.1161/STR.0b013e3182587839. - DOI - PubMed

[2] Connolly ES, Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012;43(6):1711–37. doi: 10.1161/STR.0b013e3182587839. - DOI - PubMed

[3] Teasdale GM, Drake CG, Hunt W, Kassell N, Sano K, Pertuiset B, et al. A universal subarachnoid hemorrhage scale: report of a committee of the World Federation of Neurosurgical Societies. J Neurol Neurosurg Psychiatry. 1988;51(11):1457. doi: 10.1136/jnnp.51.11.1457. - DOI - PMC - PubMed

[4] Teasdale GM, Drake CG, Hunt W, Kassell N, Sano K, Pertuiset B, et al. A universal subarachnoid hemorrhage scale: report of a committee of the World Federation of Neurosurgical Societies. J Neurol Neurosurg Psychiatry. 1988;51(11):1457. doi: 10.1136/jnnp.51.11.1457. - DOI - PMC - PubMed

[5] Soehle M, Chatfield DA, Czosnyka M, Kirkpatrick PJ. Predictive value of initial clinical status, intracranial pressure and transcranial Doppler pulsatility after subarachnoid haemorrhage. Acta Neurochir. 2007;149(6):575–83. doi: 10.1007/s00701-007-1149-6. - DOI - PubMed

[6] Soehle M, Chatfield DA, Czosnyka M, Kirkpatrick PJ. Predictive value of initial clinical status, intracranial pressure and transcranial Doppler pulsatility after subarachnoid haemorrhage. Acta Neurochir. 2007;149(6):575–83. doi: 10.1007/s00701-007-1149-6. - DOI - PubMed

[7] Lindvall P, Runnerstam M, Birgander R, Koskinen LO. The Fisher grading correlated to outcome in patients with subarachnoid haemorrhage. Br J Neurosurg. 2009;23(2):188–92. doi: 10.1080/02688690802710668. - DOI - PubMed

[8] Lindvall P, Runnerstam M, Birgander R, Koskinen LO. The Fisher grading correlated to outcome in patients with subarachnoid haemorrhage. Br J Neurosurg. 2009;23(2):188–92. doi: 10.1080/02688690802710668. - DOI - PubMed

[9] Usui A, Kato K, Murase M, Hotta T, Tanaka M, Takeuchi E, et al. Neural tissue-related proteins (NSE, G0 alpha, 28-kDa calbindin-D, S100b and CK-BB) in serum and cerebrospinal fluid after cardiac arrest. J Neurol Sci. 1994;123(1–2):134–9. doi: 10.1016/0022-510X(94)90215-1. - DOI - PubMed

[10] Usui A, Kato K, Murase M, Hotta T, Tanaka M, Takeuchi E, et al. Neural tissue-related proteins (NSE, G0 alpha, 28-kDa calbindin-D, S100b and CK-BB) in serum and cerebrospinal fluid after cardiac arrest. J Neurol Sci. 1994;123(1–2):134–9. doi: 10.1016/0022-510X(94)90215-1. - DOI - PubMed

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