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Ability of serum glial fibrillary Acidic Protein, Ubiquitin C-Terminal Hydrolase-L1, and S100B to differentiate normal and abnormal head computed tomography findings in patients with suspected mild or moderate traumatic brain injury

Welch, Robert D. (författare)
Department of Emergency Medicine, Wayne State University, Detroit, Michigan, United States
Ayaz, Syed I. (författare)
Department of Emergency Medicine, Wayne State University, Detroit, Michigan, United States
Lewis, Lawrence M. (författare)
Department of Emergency Medicine, Washington University, St. Louis, Missouri, Unites States
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Undén, Johan (författare)
Lund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Department of Anesthesiology and Intensive Care, Clinical Sciences in Malmo, Malmo, Sweden
Chen, James Y. (författare)
Department of Radiology, University of California, San Diego Health System, San Diego, California, United States
Mika, Valerie H. (författare)
Department of Emergency Medicine, Wayne State University, Detroit, Michigan, United States
Saville, Ben (författare)
Berry Consultants, Austin, Texas, United States
Tyndall, Joseph A. (författare)
Department of Emergency Medicine, University of Florida, Gainesville, Florida, United States
Nash, Marshall (författare)
Neurostudies.net, Decatur, Georgia, United States
Büki, Andras, 1966- (författare)
Department of Neurosurgery, Pecs University, Pecs, Hungary
Barzo, Pal (författare)
Department of Neurosurgery, University of Szeged, Szeged, Hungary
Hack, Dallas (författare)
U.S. Army Medical Research and Materiel Command, Fort Detrick, Maryland, United States
Tortella, Frank C. (författare)
Applied Neurobiology, Silver Spring, Maryland, United States
Schmid, Kara (författare)
Center for Military Psychiatry and Neuroscience Walter Reed Army Institute of Research, Silver Spring, Maryland, United States
Hayes, Ronald L. (författare)
Center of Innovative Research, Banyan Biomarkers, Inc., Alachua, Florida, United States
Vossough, Arastoo (författare)
Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
Sweriduk, Stephen T. (författare)
Department of Radiology, Shields Health Care Group, Brockton, Massachusetts, United States
Bazarian, Jeffrey J. (författare)
Department of Emergency Medicine, University of Rochester School of Medicine, Rochester, New York, United States
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Department of Emergency Medicine, Wayne State University, Detroit, Michigan, United States Department of Emergency Medicine, Washington University, St Louis, Missouri, Unites States (creator_code:org_t)
Mary Ann Liebert, 2016
2016
Engelska.
Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert. - 0897-7151 .- 1557-9042. ; 33:2, s. 203-214
Relaterad länk:
https://doi.org/10.1...
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https://www.liebertp...
https://portal.resea... (primary) (free)
http://www.ncbi.nlm.... (free)
http://dx.doi.org/10... (free)
https://urn.kb.se/re...
https://doi.org/10.1...
https://lup.lub.lu.s...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Head computed tomography (CT) imaging is still a commonly obtained diagnostic test for patients with minor head injury despite availability of clinical decision rules to guide imaging use and recommendations to reduce radiation exposure resulting from unnecessary imaging. This prospective multicenter observational study of 251 patients with suspected mild to moderate traumatic brain injury (TBI) evaluated three serum biomarkers' (glial fibrillary acidic protein [GFAP], ubiquitin C-terminal hydrolase-L1 [UCH-L1] and S100B measured within 6 h of injury) ability to differentiate CT negative and CT positive findings. Of the 251 patients, 60.2% were male and 225 (89.6%) had a presenting Glasgow Coma Scale score of 15. A positive head CT (intracranial injury) was found in 36 (14.3%). UCH-L1 was 100% sensitive and 39% specific at a cutoff value >40 pg/mL. To retain 100% sensitivity, GFAP was 0% specific (cutoff value 0 pg/mL) and S100B had a specificity of only 2% (cutoff value 30 pg/mL). All three biomarkers had similar values for areas under the receiver operator characteristic curve: 0.79 (95% confidence interval; 0.70-0.88) for GFAP, 0.80 (0.71-0.89) for UCH-L1, and 0.75 (0.65-0.85) for S100B. Neither GFAP nor UCH-L1 curve values differed significantly from S100B (p = 0.21 and p = 0.77, respectively). In our patient cohort, UCH-L1 outperformed GFAP and S100B when the goal was to reduce CT use without sacrificing sensitivity. UCH-L1 values <40 pg/mL could potentially have aided in eliminating 83 of the 215 negative CT scans. These results require replication in other studies before the test is used in actual clinical practice. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

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