Prediction of neuropsychological outcome after mild traumatic brain injury using clinical parameters, serum S100B protein and findings on computed tomography

Primary objective: To identify if demographics, clinical and computed tomographic (CT) characteristics at first presentation and S100B concentrations at 3 and 6 hours after mild traumatic brain injury (MTBI) predict the development of post-concussion syndrome (PCS) after 1 month. Research design and methods: All consecutive MTBI patients (Glasgow Coma Scale [GCS] score 13-15) admitted to the Emergency Department aged older than 15 were included in this prospective, observational study. Outcome was assessed using a Rivermead Post-Concussion Symptoms Questionnaire to identify the patients with and without PCS 1 month after the injury. Main outcomes and results: A total of 176 patients with isolated MTBI were included in the study. After multivariate analysis of the demographics, clinical variables, and CT abnormalities, headache (OR = 2.09, 95% CI = 1.04-4.21, p = 0.038), seizure (OR = 5.64, 95% CI = 1.55-20.54, p = 0.009), the presence of subarachnoid haemorrhage on CT (OR = 3.67, 95% CI = 1.46-9.24, p = 0.006) and 6-hour S100B concentration (OR = 2.22, 95% CI = 1.15-4.28, p = 0.017) were independently significant predictors of the outcome. Conclusions: Outcome prediction using baseline characteristics (post-traumatic headache and seizure), CT and laboratory findings (6-hour S100B) were valuable factors for identification of the individual MTBI patient at risk for developing PCS 1 month after the injury.