S100 Biomarker in the Acute Management of Mild Head Injuries

Study Overview
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Brief Summary
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A prospective validation study of the Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults. Enrolling a consecutive sample of 1000 adult head injury patients from the emergency department of the Tampere University Hospital (Tampere, Finland). A venous blood sample with S100 analytics (+storage blood) is drawn from every patient. The patients are head CT-scanned according to the SNC guidelines. Outcome assessment (GOSE, MRS, Rivermead PCS Questionnaire) is completed as follows: 1 week, 6 months, 1 year, and 2 years.

Detailed Description
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A prospective clinical head injury study conducted at the Emergency Department of the Tampere University Hospital, which is situated in Tampere, Finland. The hospital takes care of an catchment area of 524 447 inhabitants both from urban and rural areas. About 100 000 patients are treated in the Emergency department annually. The study aims to improve the emergency evaluation of patients with an acute head injury, especially a mild head injury. About 80% of head CT scan performed on head injury patients in the Emergency Department of the Tampere University Hospital are negative (= no acute traumatic lesion). There is an urgent need to update the head CT imaging criteria/indications in the context of acute head injury in order to reduce the number of unnecessary scanning. More selective head CT indications result in considerable health care savings and decreased exposure to ionizing radiation, among other benefits. In this study, the investigators implement the Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults criteria as part of the emergency care of adults head injury patients. By enrolling a large consecutive sample of patients the investigators are validating this new guideline. Emergency department assessment data is combined with long-term outcome parameters and blood-based biomarkers of neurotrauma. The main aims of the study are: the validation of the Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults the examination of novel blood-based biomarkers of acute brain injury that correlate with the radiological severity of the injury and the long-term outcome

Official Title
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S100 Biomarker in the Acute Management of Mild Head Injuries

Conditions
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Brain Injury, Head Injury

Intervention / Treatment
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* Other: Indications for head CT imaging after acute head injury


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Head injury Exclusion Criteria: Age under 18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Indications for head CT imaging after acute head injury|Indications for head CT imaging after acute head injury as per the Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Non-contrast head CT | Head CT findings: Intracranial traumatic lesions | 0-72h | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Glasgow Outcome Scale Extended | Glasgow Outcome Scale Extended | 1 week, 6 months, 1 year, and 2 years | 
| Modified Rankin Scale | Modified Rankin Scale | 1 week, 6 months, 1 year, and 2 years | 
| Rivermead PCS Questionnaire | Rivermead PCS Questionnaire | 1 week, 6 months, 1 year, and 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Brain injury, Head injury, Computed tomography, Emergency department