Objective: To compare the classification accuracy of S100B to two clinical decision rules- Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC)-for predicting traumatic intracranial injuries (ICI) after mild traumatic brain injury (mild TBI).Methods: A secondary analysis of a prospective observational study of mild TBI patients was performed. The diagnostic performance of S100B for predicting ICI on head CT was compared to both the CHRR and NOC. Area under receiver operator characteristic (AUC) curves were used and multivariable analysis was used to create a new decision rule based on a combination of S100B and decision rule-related variables.Results: S100B had the highest negative predictive value (97.3%), positive predictive value (7.21%), specificity (33.6%) and positive likelihood ratio (1.3), and the lowest negative likelihood ratio (0.5). The proportion of mild TBI subjects with potentially avoidable head CT scans was highest using S100B (37.7%). The addition of S100B to both clinical decision rules significantly increased AUC. A novel decision rule adding S100B to three decision rule-related variables significantly improved prediction (p < 0.05).Conclusion: Serum S100B outperformed clinical decision rules for identifying mild TBI patients with ICI. Incorporating clinical variables with S100B maximized ICI prediction, but requires validation in an independent cohort.

中文翻译：

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S100B 在轻度创伤性脑损伤后头部 CT 扫描中识别颅内损伤的临床决策规则优于临床决策规则。

目的：比较S100B与两种临床决策规则——加拿大CT头部规则（CCHR）和新奥尔良标准（NOC）——预测轻度创伤性脑损伤（轻度TBI）后颅内损伤（ICI）的分类准确性。方法：对轻度 TBI 患者的前瞻性观察研究进行了二次分析。将 S100B 在头部 CT 上预测 ICI 的诊断性能与 CHRR 和 NOC 进行了比较。使用受试者操作特征 (AUC) 曲线下面积并使用多变量分析创建基于 S100B 和决策规则相关变量组合的新决策规则。 结果：S100B 具有最高的阴性预测值 (97.3%)，阳性预测值 (7.21%)、特异性 (33.6%) 和阳性似然比 (1.3) 以及最低的阴性似然比 (0. 5）。使用 S100B 进行可能可避免的头部 CT 扫描的轻度 TBI 受试者的比例最高 (37.7%)。将 S100B 添加到两个临床决策规则显着增加了 AUC。将 S100B 添加到三个决策规则相关变量的新决策规则显着改善了预测 (p < 0.05)。结论：血清 S100B 在识别轻度 TBI 患者的 ICI 方面优于临床决策规则。将临床变量与 S100B 结合可最大化 ICI 预测，但需要在独立队列中进行验证。0.05).结论：血清S100B优于识别轻度TBI ICI患者的临床决策规则。将临床变量与 S100B 结合最大化 ICI 预测，但需要在独立队列中进行验证。0.05).结论：血清S100B优于识别轻度TBI ICI患者的临床决策规则。将临床变量与 S100B 结合可最大化 ICI 预测，但需要在独立队列中进行验证。