DOS 2016

DOS Kongressen 2016 ·

235

The use of blood test S-100b as biomarker for

intracranial haemorrhage in adult patients with

mild head injury in Danish Emergency Departments

Anders Kjærsgaard Valen, Karen Toftdahl Bjørnholdt, Bent Lund

Department of Orthopedic Surgery, Regional Hospital of Horsens; Department

of Orthopedic Surgery, Regional Hospital of Horsens; Department of Orthopedic

Surgery, Regional Hospital of Horsens

Background:

Traumatic head injuries account for frequent visits in Danish

Emergency Departments (ER) with more than 20.000 visits yearly and 25 daily

hospital admissions. An estimated 90 per cent have mild head injury (MHI) with

GCS 14-15. The diagnostic approach has been notoriously challenging espe-

cially regarding the use of CT-C. In 2013 the blood test S-100b was introduced

in the revised guidelines regarding management of these patients. S- 100b is

designed to rule out intracranial haemorrhage in selected adult patients with

MHI thereby possibly avoiding excessive use of CT-scans. The test is widely

used in many European countries. However, it remains unclear to what extent it

is being used in Danish ERs.

Purpose / Aim of Study:

An observational study was conducted to quantify

the number of Danish ERs using S- 100b. In addition, the yearly number of re-

quested tests was found.

Materials and Methods:

During March 2016 the major ERs in Denmark

(n=30) were contacted regarding their ability to use S-100b. The departments

that were able to use S-100b were subsequently contacted concerning how

many tests were made during 2015.

Findings / Results:

Response rate was 100 per cent. 20 per cent (6/30) of

the ERs were able to do in- house analysis of blood work for S-100b. Some

16,7 per cent (5/30) were able to request the test and have it transported to

larger nearby hospitals for analysis. However, this opportunity was not used. On

average the six ERs that were able to use S-100b requested 335 tests during

2015.

Conclusions:

The results indicate that Danish ERs do not routinely use S-100b

despite recent recommendations. The ERs able to request the test use it to a

limited extent. The reasons for this reluctance should be further investigated.

More studies are yet to be made to clarify whether the use of S-100b results in

less CT-scans and admissions in a Danish setting.

No conflicts of interest reported

186.