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<p>The sampling of S100B protein has been proposed as a screening tool to identify patients with a low risk of post-traumatic intracranial hemorrhage. Its performance for patients on antiplatelet agents or anticoagulants is still debatable. This exploratory study evaluates the diagnostic accuracy of S100B concentrations, measured within 3&#xa0;h of head trauma, to rule out intracranial hemorrhage in adults on antiplatelet or anticoagulant therapy. This prospective study enrolled adult patients presenting for head trauma within the last 3&#xa0;h and under antiplatelets or anticoagulants. We hypothesized that a S100B concentration under 0,100&#xa0;µg.L<sup>-1</sup> rule out intracranial hemorrhage with a negative predictive value over 0,99. Sensitivity, specificity, positive predictive value and negative predictive value were analyzed. From June 2020 to January 2023, 155 patients were included. 119 patients had a S100B level at 0,100&#xa0;µg.L<sup>-1</sup> or over. 8 had an intracranial hemorrhage. The sensitivity of S100B was 1 (95%CI 0,68–1), specificity was 0,25 (95%CI 0,18 − 0,32), positive predictive value was 0,07 (95%CI 0.03–0.13), negative predictive value was 1 (95%CI 0,90 − 1). This study suggests that when performed in a 3-hour period after mild head trauma, S100B measurement is an accurate screening tool to rule out intracranial hemorrhage in patients treated with antiplatelet agents or anticoagulants.</p>

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Diagnostic performance of S100B assay for intracranial hemorrhage detection in patients with mild traumatic brain injury under antiplatelet or anticoagulant therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月17日

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  • Paul-André Poislane,
  • Mathilde Papin,
  • Damien Masson,
  • Nicolas Goffinet,
  • Arthur David,
  • Quentin Le Bastard,
  • Hugo De Carvalho

摘要

The sampling of S100B protein has been proposed as a screening tool to identify patients with a low risk of post-traumatic intracranial hemorrhage. Its performance for patients on antiplatelet agents or anticoagulants is still debatable. This exploratory study evaluates the diagnostic accuracy of S100B concentrations, measured within 3 h of head trauma, to rule out intracranial hemorrhage in adults on antiplatelet or anticoagulant therapy. This prospective study enrolled adult patients presenting for head trauma within the last 3 h and under antiplatelets or anticoagulants. We hypothesized that a S100B concentration under 0,100 µg.L-1 rule out intracranial hemorrhage with a negative predictive value over 0,99. Sensitivity, specificity, positive predictive value and negative predictive value were analyzed. From June 2020 to January 2023, 155 patients were included. 119 patients had a S100B level at 0,100 µg.L-1 or over. 8 had an intracranial hemorrhage. The sensitivity of S100B was 1 (95%CI 0,68–1), specificity was 0,25 (95%CI 0,18 − 0,32), positive predictive value was 0,07 (95%CI 0.03–0.13), negative predictive value was 1 (95%CI 0,90 − 1). This study suggests that when performed in a 3-hour period after mild head trauma, S100B measurement is an accurate screening tool to rule out intracranial hemorrhage in patients treated with antiplatelet agents or anticoagulants.