La protéine S100B est-elle un outil de dépistage valide pour réduire le nombre de tomodensitométries inutiles suite à un traumatisme cranio-cérébral léger?

 

Natalie Le Sage

Centre de recherche du CHU de Québec-Université Laval

 

Domaine : santé des populations

Programme consortium pour le développement de la recherche en traumatologie - Volet 1

Concours 2017-2018

Introduction. Mild traumatic brain injuries (TBI) are a common problem affecting people from all strata of society. To help guide clinicians in the use of computed tomography (CT), a decision rule, Canadian CT Head Rule, was elaborated with the aim of decreasing the proportion of unnecessary CT scans in patients with a mild TBI. Furthermore, some authors suggested that the protein S-100β could also be used as a diagnostic tool in order to reduce CT scans. However, as of now, none of the models described in the literature has been validated.

Objectives. The principal objective is to develop and validate a new clinical decision rule to detect significant traumatic lesions assessed using a CT scan by combining the S-100β protein with the CCHR. The secondary objective is to undertake an external and independent validation of models, previously proposed in the literature, in terms of sensitivity, specificity, positive predictive value, and negative predictive value to predict significant lesions following a mild TBI.

Methods. Using a cohort of approximately 500 patients who have incurred a mild TBI and were recruited within 24 hours of their trauma, we will develop and validate a new model that integrates S-100β protein with the CCHR and then estimate the proportion of unnecessary CT scans that could be avoided using this model. For every relevant model in the literature, we will calculate the sensitivity, specificity, positive predictive value, and negative predictive value to predict significant hemorrhagic lesions as assessed using CT scan following mild TBI.