ABSTRACT
Objective:To investigate the changes and clinical significance of serum S100β and neuron-specific enolase (NSE) levels of children with acute brain injury(ABI).Methods:100 children with ABI treated in the pediatric intensive care unit (PICU) of the Affiliated Hospital of Inner Mongolia Medical University from June 2019 to June 2020 were prospectively selected as the ABI group, and 30 normal children in the children′s health clinic of the hospital were selected as the control group. The serum S100β and NSE levels of all subjects was detected. According to the Glasgow Coma Scale (GCS), children with ABI were divided into severe brain injury group ( n=26), moderate brain injury group ( n=35) and mild brain injury group ( n=39). The prognosis of children with ABI after 3 months of treatment was evaluated according to the Glasgow prognosis scale (GOS) and they were divided into poor prognosis group ( n=26) and good prognosis group ( n=74). The relationship between serum S100β and NSE levels and the severity and prognosis of children with ABI was analyzed. Results:The serum S100β and NSE levels in the ABI group were significantly higher than those in the control group, and the serum S100β and NSE levels in children with ABI increased with the severity of injury and poor prognosis ( P<0.05). Pearson correlation analysis showed that serum S100β and NSE levels in children with ABI were positively correlated with GCS scores ( r=0.521, 0.643, P<0.05). Multiple logistic regression analysis showed that glucose(GLU) ( OR=1.631, 95% CI: 1.278-2.082), S100β ( OR=1.907, 95% CI: 1.558-5.877), NSE ( OR=2.896, 95% CI: 1.193-7.029) were independent prognostic factor in children with ABI ( P<0.05). Receiver operating characteristic (ROC) curve showed that the sensitivity, specificity and accuracy of serum S100β+ NSE [area under curve (AUC)=0.932, 95% CI: 0.875-0.969] in predicting the poor prognosis of children with ABI were higher than those of serum S100β(AUC=0.728, 95% CI: 0.643-0.803), NSE (AUC=0.808, 95% CI: 0.729-0.871) alone. Conclusions:The levels of serum S100β and NSE in children with ABI aresignificantly increased, which are closely related to the severity of the disease and prognosis. They can be used as predictors of poor prognosis in children with ABI. Combined detection can enhance the diagnostic value.
ABSTRACT
Introduction Motor vehicle transport is common everywhere and in our local setting, most travel using their own cars. Resumption of driving after acquired brain injury (ABI) has been shown to affect subsequent community integration. Forty four to 66% of ABI survivors return to driving according to studies elsewhere. This study assesses the number of patients who resumed driving after ABI in Brunei Darussalam. Materials and Methods Brunei Darussalam citizens after ABI who were above 18 years old and had received occupational therapy in RIPAS Hospital, Brunei Darussalam between June 1, 2008 and May 31, 2009 were retrospectively identified and studied. Data was collected from the Department of Occupational Therapy records supplemented by telephone calls to patients or their relatives. Results Of 111 patients included in the study, 43 patients did not drive prior to ABI, since they were either older in age or never had a driving license. Of those with driving licenses (68) prior to ABI, 15 (22%) resumed driving: traumatic brain injury (n=1/5, 20%), brain tumour (n=1/4, 25%), brain infection (n=1/1, 100%) and for stroke (n=12/58, (20.7%). Gender and age groups were not significant predictors of return to driving. Conclusion Only 22% of Bruneians after ABI resumed driving and this is lower than studies elsewhere. Reasons considered include severity of injury and cultural factors which all require further study.