Evaluation of serum S100B as a biomarker of head injury in patients admitted into a neurological ward at Parirenyatwa hospital, Harare, Zimbabwe

Abstract

Background: - CT scanning is the gold standard for head injury diagnosis. However, the high costs of imaging in Zimbabwe makes it difficult to manage patients with head injuries as most admitted in public hospital are unable to pay for the services. Use of cheaper serum biomarkers may improve patient management. Serum S100B has been introduced as a clinical tool for diagnosis of traumatic brain injury in some emergency departments in European healthcare facilities and has been reported as reducing the frequency of unnecessary CT scans. Aim: - To validate the clinical utility of serum S100B in patients with head injury. Materials and methods: - A cross sectional study in which 50 patients with suspected head injuries, 20 apparently healthy health workers and 20 non neurological patients in medical wards were enrolled at Parirenyatwa hospital. Blood samples were withdrawn from head injury suspects within 24 hours of admission and leftover serum samples for the non neurological patients were collected from Parirenyatwa Hospital laboratory. Serum S100B levels were measured and results were correlated with CT scan findings, Glasgow coma scale and Glasgow outcome scale obtained from audit reports. Results from head injury suspects were also compared with those of apparently healthy participants and those from patients with non neurological conditions. Results: - Serum S100B levels were significantly higher in head injury patients [median 173.25 (IQR 50- 428.1)] compared to apparently healthy participants [median 8.3 (IQR 5.25- 9.8)] and non neurological participants [median 12.75 (IQR 12.75- 18.2)] p <0.001. Of the 50 head injury patients only 29 had a CT scan done of which 25 were positive.