S100B and brain ultrasound: Novel predictors for functional outcome in acute ischemic stroke patients

医学 改良兰金量表 接收机工作特性 冲程(发动机) 内科学 观察研究 多元分析 大脑中动脉 心脏病学 缺血性中风 缺血 机械工程 工程类
作者
Ahmed Hawash,Tayseer Zaytoun,Tamer A. Helmy,Ehab Mahmoud El reweny,Aya Mohamed Ahmed Abdel Galeel,Raghda Saad Zaghloul Taleb
出处
期刊:Clinical Neurology and Neurosurgery [Elsevier BV]
卷期号:233: 107907-107907
标识
DOI:10.1016/j.clineuro.2023.107907
摘要

Stroke is a leading cause of mortality and disability worldwide. This study aimed to assess the prognostic value of serum S100B protein, transcranial color-coded duplex sonography (TCCD), and optic nerve sheath diameter (ONSD) in predicting functional outcomes in critically ill patients with acute ischemic stroke (AIS). In this prospective observational study, 80 adult AIS patients were evaluated. Serum S100B protein levels, ONSD, and middle cerebral artery pulsatility index (MCA PI) were measured on days 1 and 3. Functional outcomes at 90 days were assessed using the modified Rankin Scale (mRS) and categorized into favourable (mRS 0-2) or unfavourable (mRS 3-6) groups. The association of demographic, clinical, laboratory, and imaging parameters with mRS outcomes was analyzed. Poor mRS outcomes occurred in 82.5% of patients. Factors significantly associated with poor outcomes were female sex, higher National Institutes of Health Stroke Scale (NIHSS) scores on days 1, 3, and 7, and larger stroke size. Receiver Operating Characteristic (ROC) curve analysis revealed that ONSD at days 1 and 3, serum S100B levels at day 1, and right MCA PI at day 1 had significant predictive value for poor mRS outcome. Multivariate analysis identified female sex, S100B on day 1, and NIHSS on days 1, 3, and 7 as independent predictors of poor mRS outcomes. The combination of S100B, ONSD, and MCA PI improved the prediction of functional outcomes in critically ill AIS patients. Early S100B measurement and brain ultrasound evaluation may serve as valuable prognostic tools for guiding therapeutic decision-making. This study provides novel insights into the role of S100B and brain ultrasound in stroke outcome prediction, particularly in critically ill AIS patients.
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