Effect of serum S100B level in the management of pediatric minor head trauma

A recent study demonstrated the efficacy of serum S100B level in managing pediatric minor head trauma through a decrease in the need for cranial computed tomographic (CCT) scans and hospital observation when monitored according to a specific clinical decision algorithm. This study’s findings were published in the journal, JAMA network open.

In this multicenter, prospective, interventional randomized clinical trial, children and adolescents aged 16 years or younger were enrolled. The control group [n= 926] underwent CCT scans or were hospitalized as per the prevailing recommendations. In the S100B biomonitoring group [n=1152], blood sampling was conducted within 3 hours after minor head trauma, and the subsequent management was contingent upon the levels of serum S100B protein. If the S100B level was within the reference range suitable for the child's age, they were discharged from the emergency department. Otherwise, they received the same treatment as the control group. The main outcome of the study was the proportion of patients who underwent CCT scans within 48 hours after experiencing a minor head trauma.

At the end of the study, 299 children (32.3%) in the control group and 112 (9.7%) in the S100B biomonitoring group underwent cranial CT scans. A substantial 50% decline in hospitalizations was observed in the S100B biomonitoring group (479 [41.6%] vs 849 [91.7%]).

Based on the above results, it can be concluded that implementation of S100B biomonitoring resulted in a decline in the number of CCT scans required and the duration of in-hospital monitoring when assessed based on the criteria outlined in a clinical decision algorithm.