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Biomarkers May Predict Unfavorable Neurological Outcome after Mild Traumatic Brain Injury
- Source :
- Journal of neurotrauma. 37(24)
- Publication Year :
- 2020
-
Abstract
- The objective of this study was to determine if initial or repeat measurements of serum concentrations of glial fibrillary acidic protein (GFAP) or ubiquitin C-terminal hydrolase L1 (UCH-L1) are predictive of an acute unfavorable neurological outcome in patients who present to the emergency department (ED) with brain injury and an initial Glasgow Coma Scale Score (GCS) of 14-15. This multi-center observational trial included brain-injured adults presenting to the ED, receiving a head computed tomography (CT) and venipuncture for biomarker concentration measurements within 6 h of injury. Subjects had repeat serum sampling and GCS scores every 4 h for the first 24 h, if available for assessment. We analyzed blood samples using an enzyme-linked immunosorbent assay approved by the Food and Drug Administration (FDA). Wilcoxin two-sample test was used to compare initial and repeat serum concentrations for both biomarkers between CT-positive patients who did not have an acute unfavorable neurological outcome and those patients who did. A total of 145 enrolled subjects had adequate data for analysis; 69 were CT-positive, 74 were CT-negative, and 2 were CT-inconclusive. Five subjects developed an acute unfavorable neurological outcome, defined as need for intracranial pressure monitoring, craniotomy, persistent neurological deficits, or death resulting from brain injury. Initial median serum concentrations of GFAP and UCH-L1 (obtained6 h from injury) were significantly greater in CT-positive patients who had an acute unfavorable neurological outcome than in CT-positive patients who did not (GFAP: 5237 pg/mL [IQR 4511, 8180] versus 283.5 pg/mL [IQR 107, 1123]
- Subjects :
- Adult
Male
030506 rehabilitation
Pathology
medicine.medical_specialty
Traumatic brain injury
Head trauma
03 medical and health sciences
0302 clinical medicine
Ubiquitin
Hydrolase
Glial Fibrillary Acidic Protein
Medicine
Humans
Brain Concussion
Aged
Glial fibrillary acidic protein
biology
business.industry
Recovery of Function
Serum concentration
Middle Aged
medicine.disease
nervous system
biology.protein
Female
Neurology (clinical)
0305 other medical science
business
Ubiquitin Thiolesterase
030217 neurology & neurosurgery
Biomarkers
Subjects
Details
- ISSN :
- 15579042
- Volume :
- 37
- Issue :
- 24
- Database :
- OpenAIRE
- Journal :
- Journal of neurotrauma
- Accession number :
- edsair.doi.dedup.....2354f7a998d43955be62bcd64de2b69e