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Day-of-injury blood test predicts which TBI patients are more likely to die or survive severely disabled

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Studies show that blood tests taken on the day of a traumatic brain injury can predict which patients are more likely to die or survive severely disabled, thus helping clinicians identify possible treatments for TBI. can make early decisions about

Researchers at the Medical College of Michigan, the University of California, San Francisco, and the University of Pennsylvania analyzed blood tests from about 1,700 TBI patients on the day of injury.results published in lancet neurology found that higher levels of two protein biomarkers, GFAP and UCH-L1, were associated with death and serious injury.

This is the first study to examine the association between biomarker levels of these two proteins and all-cause mortality after traumatic brain injury, says lead author and associate professor of emergency medicine at the University of Michigan School of Medicine. One Frederick Korley, MD, said:

Early and accurate prediction of traumatic brain injury prognosis will help clinicians gauge the severity of brain injury and advise families on what to expect regarding the care and recovery of loved ones with brain injury. It helps inform how best to do it. It also helps researchers target promising TBI therapeutics more precisely to the right TBI patients. ”


Frederick Korley, MD, Ph.D., Associate Professor of Emergency Medicine, University of Michigan School of Medicine

The U.S. Food and Drug Administration approved the use of GFAP and UCH-L1 in 2018 to help clinicians decide whether to order a CT scan for mild traumatic brain injury.

Researchers measured protein using two instruments from Abbott Laboratories, i-STAT Alinity and ARCHITECT. Results were compared to assessments made 6 months after his injury using the Glasgow Outcome Scale-Extended, a system for assessing functional status in patients with TBI.

The researchers found that people with GFAP values ​​in the top 20th percentile had a 23-fold higher risk of death over the next six months than those with GFAP values ​​in the bottom 20th percentile. Similarly, those with UCH-L1 values ​​in the top 20th percentile had a 63-fold higher risk of death during her subsequent six months than those with UCH-L1 values ​​in the bottom 20th percentile.

“Modern trauma care can bring positive outcomes to injuries we once believed could not survive,” said Geoffrey Manley, co-lead author and professor of neurosurgery and vice chair at UCSF, MD, Ph.D. said. “These blood tests not only provide both diagnosis and prognosis, they are easy to administer, safe and inexpensive.”

This method shows promise in determining poor prognosis for moderate and severe traumatic brain injury, but researchers need to do more to examine its role in mild cases. said.

“As a next step, the TRACK-TBI team is planning a clinical trial. efficacy of “As part of this clinical trial, these biomarkers will be used as an objective method to select suitable patients to enroll in this trial. We monitor individual patient responses to therapeutic modalities.”

sauce:

Journal reference:

Corey, FK, and others. (2022) Prognostic value of day-of-injury plasma GFAP and UCH-L1 concentrations to predict functional recovery after traumatic brain injury in patients from the US TRACK-TBI cohort: an observational cohort study. Lancet Neurology. doi.org/10.1016/S1474-4422(22)00256-3.

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