Abstract
BACKGROUND: Glial fibrillary acidic protein (GFAP) and
ubiquitin C-terminal hydrolase-
L1 (UCH-L1) are promising biomarkers of traumatic brain
injury (TBI).
OBJECTIVE: We investigated the relation of the GFAP and
UCH-L1 levels to the severity
of TBI during the first week after injury.
METHODS: Plasma UCH-L1 and GFAP were measured from 324
consecutive patients
with acute TBI and 81 control subject enrolled in a
2-center prospective study. The
baseline measures included initial Glasgow Coma Scale
(GCS), head computed tomographic
(CT) scan at admission, and blood samples for protein
biomarkers that were
collected at admission and on days 1, 2, 3, and 7 after
injury.
RESULTS: Plasma levels of GFAP and UCH-L1 during the
first 2 days after the injury strongly
correlated with the initial severity of TBI as assessed
with GCS. Additionally, levels of UCH-L1
on the seventh day after the injury were significantly
related to the admission GCS scores. At
admission, both biomarkers were capable of distinguishing
mass lesions from diffuse injuries
in CT, and the area under the curve of the
receiver-operating characteristic curve for prediction
of any pathological finding in CT was 0.739 (95%
confidence interval, 0.636-0.815)
and 0.621 (95% confidence interval, 0.517-0.713) for GFAP
and UCH-L1, respectively.
CONCLUSION: These results support the prior findings of
the potential role of GFAP
and UCH-L1 in acute-phase diagnostics of TBI. The novel
finding is that levels of GFAP
and UCH-L1 correlated with the initial severity of TBI
during the first 2 days after the
injury, thus enabling a window for TBI diagnostics with
latency.
Original language | English |
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Pages (from-to) | 456-464 |
Journal | Neurosurgery |
Volume | 79 |
Issue number | 3 |
DOIs | |
Publication status | Published - 2016 |
MoE publication type | A1 Journal article-refereed |
Keywords
- biomarker
- GFAP
- Severity
- traumatic brain injury
- UCH-L1