Background: Mild head injury represents an important source of medical morbidity-mortality to the medical society. Accurate prediction of outcome can help clinically, allow early rehabilitation and assess medico legal responsibility of health care providers. Purpose and objectives: We aimed, in this work, to study the possibility of using an alternative method such as the S100 protein to predict the presence of an intracranial pathology and thus decreasing the number of patients exposed to unnecessary imaging radiation.
Patients and Methods: a single-center prospective cohort study that was carried out from January 2018 to January 2019 at Benha University Hospital.
Results: A total of 106 patients presented to the Emergency Department of Benha University Hospital with Glasgow Coma Scale (GCS) 13-15 after head injury. They were 60 males and 46 females their age ranges from 6 to 72 years. The mechanism of trauma included road traffic accidents (RTA) in 53 patients (50%), falling from a height in 29 patients and direct trauma in 24 patients. Trauma- related intracranial pathologies were detected in 19 patients as seen by MRI images. Those pathologies were evident on CT in only 6 patients (31.5%). Detection of S100B protein could predict the presence of those pathologies in 18 patients (sensitivity 94.7%) with a false negative result in only one patient. S100 B protein was positive in 4 patients with trauma unrelated pathologies on their MRIs (specificity 81.8%).
Conclusions: Measuring S100B levels in the management of mild head injury may prevent unnecessary CT scans, which are currently recommended for patients with mild head injury, and thus reduce radiation exposure and save precious healthcare resources. Moreover, precise diagnosis and prediction of outcome may solve many problems of medico legal importance as the impact of malpractice on doctors due to delay in interference or absence of facilities.
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