| Waterloo K et al, 2005, Norway | 7 patients with high S-100b after mild head injury matched with 7 patients with no detectable S-100b | Case control study | Overall cognitive function | No difference | |
| | | Reaction time | Increased in raised S-100b group | |
| | | Attention | Reduced in raised S-100b group | |
| Rothoerl et al, 1998, Germany | 30 patients with a severe head injury (GCS< = 9) and 11 with minor head injury (GCS 13-15) admitted to a neurosurgical unit | Diagnostic Cohort study (4) | Glasgow Outcome Scale on discharge (Mean day 19 in severe group and mean day 1.3 in minor head injury group) | Patients with GOS 3-5 S-100 level mean 1.2mcg SD 1.8 | Non-independent gold standard |
| S-100 levels measured mean 2.5 hrs after injury | | Detectable level of S-100 (>0.5mcg/l) | Patients with GOS 1-2 (unfavourable) S-100 level mean 4.9mcg/l SD 5.3 | Small, selected cohort of patients |
| | | | P = 0.0025 | |
| | | | 25 of 27 Elevated S-100 levels were found in the minor head injury group | |
| Raabe A et al, 1999, Germany | 82 patients after severe head injury (GCS< = 8) | Diagnostic cohort study (2b) | Glasgow outcome score at 6 months | For S-100 level of >2.5mcg/l, unfavourable outcome was predicted with | No confidence intervals presented |
| s-100 taken at admission and every 24 hours | | Unfavourable outcome defined as severe disability or vegetative state | Sensitivity 44% | Non-consecutive |
| | | | Specificity 97% | |
| Woertgen et al, 1999, Germany | 44 patients after severe head injury (GCS score < = 8) | Diagnostic cohort study (3b) | Glasgow outcome score calculated at mean 11 months after trauma (GOS 1-3 unfavourable) | For S-100 level of >2mcg/l, PCS symptoms predicted with | Tables 2, 3 and 4 are incorrect, with erratum printed in a later edition |
| S-100 taken 1-6 hrs after injury | | | Sensitivity 95% | |
| | | | Specificity 70% | |
| Ingebrigtsen et al, 1999, Sweden | 50 patients with minor head injury and LOC (GCS 13-15) referred to Neurosurgery dept after CT scan | Diagnostic Cohort study (3b) | Neuropsychological testing at 3 months (for attention, psychomotor speed, trail-making test, memory, digit span) In 36 patients | 11/36 patients had S-100 >0.2mcg/l | Very small study with no sample size estimates |
| S-100 taken hourly up to 12 hours | | MRI and CT scan findings within 48hrs | There were non significant trends to reduced impairment in the S-100 negative group | Non consecutive |
| | | | 4 of 5 patients with brain contusion had S-100 >0.4mcg/l | Only 36 of 50 patients followed up at 3 months |
| | | | Sensitivity 80% (p = 0.035) | |
| Ingebrigsten et al 2000 Scandinavia (3 centres Sweden, Denmark, Norway) | 182 patients from 3 centres with GCS 13-15 and brief Loss of Consciousness. | Diagnostic Cohort Study (2b) | Rivermead postconcussion symptoms questionnaire score (RPQ) | Patients with a positive S-100 had mean RPQ 6.0 vs 4.0 in S-100 negative group p = 0.07 | No sensitivities or specificities given for prediction of long term disability |
| S-100 taken on admission | | Intracranial Pathology on CT scan at <24 hours | Detectable S-100 predicted intracranial pathology with: Sensitivity 90%, Specificity 65% | |
| Mussack T et al, 2000, Germany | 80 patients presenting with a history of minor head trauma (GCS 13-15) | Diagnostic study (4) | S-100 in Minor Head Trauma pts | Patients discharged < = 6hrs 0.29 +/- 0.11 ng/ml | No gold standard outcome measures |
| Also 10pts with severe head injury (GCS<8) | | Patients with Severe head Injury GCS<8 | Patients discharged > = 24hrs 0.70 +/- 0.19 ng/ml | Non consecutive |
| S-100 taken at 0h, 6h and 24hrs post admission | | | Patients subsequently admitted to ICU 5.03 +/- 3.18 ng/ml | Results not clearly presented |
| 50 patients GCS 13-15 after normal CT scan | | | 5.26 +/- 1.56ng/ml | Non significant findings between groups |
| | | | | Low number of patients |
| Herrmann et al, 2001, Germany | 69 patients admitted to a neurosurgical unit (mostly GCS >13) | Diagnostic study (3b) | Intracranial pathology on CT scan at 2 weeks and 6 months, or focal neurology | At 2 weeks, S-100 of >0.14mcg/l predicted positive outcome: | Inclusion criteria for patients unclear |
| S-100 taken at 1, 2 and 3 days | | | Sensitivity 69% | Only 29 patients followed up to 6 months |
| | | | Specificity 90% | |
| | | | At 6 month, S-100 of >0.14mcg/l predicted positive outcome: | |
| | | | Sensitivity 65% | |
| | | | Specificity 89% | |
| Chatfield DA et al, 2002, UK | 20 patients with severe head injury (GCS< = 8) admitted to neurosurgical unit | Diagnostic cohort study (4) | Glasgow outcome score at 6 months after trauma (GOS 1-3 unfavourable) | Patients with GOS 1-3 S-100 mean level 2.46 +/-0.32mcg/l | Data not clearly presented |
| s-100 on admission | | | Patients with GOS 3-5 S-100 mean level 0.6 +/-0.1mcg | Small study |
| | | | P<0.05 | No cut off points or ROC curves calculated |
| Townend WJ et al, 2002, UK | 148 adult head injury patients (GCS 4-15) in 4 hospitals. Most had a minor head injury | Diagnostic study (2b) | Extended Glasgow outcome score at 1 month | S-100>0.32mcg/l predicted severe disability (15 patients with GOSE<5): | Wide confidence intervals |
| S-100 levels taken within 6 hours of head injury | | | Sensitivity 93% (63%-100%) | Non consecutive |
| | | | Specificity 72% (54%- 79%) | Wide definition of head injury (including no LOC) |
| | | | NPV 99% (93%-100%) | 80% follow up rate |
| Spinella et al, 2003, USA | 27 children (<18yrs) with traumatic brain injury | Diagnostic cohort study (3b) | Pediatric Cerebral performance category score (PCPC) assessed at discharge and 6 months | For s-100 level of >2.0mcg/l, unfavourable outcome was predicted with | Very small study |
| S-100 taken within 12 hours | | | Sensitivity 86% | Confidence intervals not given |
| | | | Specificity 95% | Non consecutive |
| Savola O & Hillbom M, 2003, Finland | 172 consecutive patients with mild head injury (GCS 13-15) | Diagnostic cohort study (2b) | Post concussional symptoms defined by Rivermead Post-Concussion Symptoms Questionnaire at 2–6 weeks | For s-100 level of >0.50mcg/l, PCS symptoms predicted with | No confidence intervals or sample size calculations |
| | | | Sensitivity 27% | |
| | | | Specificity 93% | |