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  • Czeiter, EndreDepartment of Neurosurgery, Medical School, University of Pecs, H-7623 Pecs, 2 Ret Street, Hungary; Department of Anatomy, Medical School, University of Pecs, Pecs, Hungary (author)

Brain Injury Biomarkers May Improve the Predictive Power of the IMPACT Outcome Calculator

  • Article/chapterEnglish2012

Publisher, publication year, extent ...

  • Mary Ann Liebert,2012
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-113238
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-113238URI
  • https://doi.org/10.1089/neu.2011.2127DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies:United States Department of DefenseUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USAUniversity of FloridaDeveloping Competitiveness of Universities in the South Transdanubian RegionMTA-PTE Clinical Neuroscience MR Research GroupETTBanyan Biomarkers, Inc. 
  • Outcome prediction following severe traumatic brain injury (sTBI) is a widely investigated field of research. A major breakthrough is represented by the IMPACT prognostic calculator based on admission data of more than 8500 patients. A growing body of scientific evidence has shown that clinically meaningful biomarkers, including glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), and alpha II-spectrin breakdown product (SBDP145), could also contribute to outcome prediction. The present study was initiated to assess whether the addition of biomarkers to the IMPACT prognostic calculator could improve its predictive power. Forty-five sTBI patients (GCS score <= 8) from four different sites were investigated. We utilized the core model of the IMPACT calculator (age, GCS motor score, and reaction of pupils), and measured the level of GFAP, UCH-L1, and SBDP145 in serum and cerebrospinal fluid (CSF). The forecast and actual 6-month outcomes were compared by logistic regression analysis. The results of the core model itself, as well as serum values of GFAP and CSF levels of SBDP145, showed a significant correlation with the 6-month mortality using a univariate analysis. In the core model, the Nagelkerke R-2 value was 0.214. With multivariate analysis we were able to increase this predictive power with one additional biomarker (GFAP in CSF) to R-2 = 0.476, while the application of three biomarker levels (GFAP in CSF, GFAP in serum, and SBDP145 in CSF) increased the Nagelkerke R-2 to 0.700. Our preliminary results underline the importance of biomarkers in outcome prediction, and encourage further investigation to expand the predictive power of contemporary outcome calculators and prognostic models in TBI.

Subject headings and genre

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  • Mondello, StefaniaDepartment of Anesthesiology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States; Department of Clinical Programs, Center of Innovative Research, Banyan Biomarkers, Inc., Alachua, FL, United States (author)
  • Kovacs, NoemiDepartment of Neurosurgery, Medical School, University of Pecs, H-7623 Pecs, 2 Ret Street, Hungary (author)
  • Sandor, JanosDivision of Biostatistics and Epidemiology, Faculty of Public Health, University of Debrecen, Debrecen, Hungary (author)
  • Gabrielli, AndreaDepartment of Anesthesiology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States (author)
  • Schmid, KaraDepartment of Applied Neurobiology, Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, United States (author)
  • Tortella, FrankDepartment of Applied Neurobiology, Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD, United States (author)
  • Wang, Kevin K. W.Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, United States; Department of Diagnostic Research and Development, Center of Innovative Research, Banyan Biomarkers, Inc., Alachua, FL, United States (author)
  • Hayes, Ronald L.Department of Anesthesiology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States; Department of Clinical Programs, Center of Innovative Research, Banyan Biomarkers, Inc., Alachua, FL, United States (author)
  • Barzo, Pal (author)
  • Ezer, Erzebet (author)
  • Doczi, Tamas P.Department of Neurosurgery, Medical School, University of Pecs, H-7623 Pecs, 2 Ret Street, Hungary (author)
  • Büki, Andras,1966-Department of Neurosurgery, Medical School, University of Pecs, H-7623 Pecs, 2 Ret Street, Hungary(Swepub:oru)asbi (author)
  • Department of Neurosurgery, Medical School, University of Pecs, H-7623 Pecs, 2 Ret Street, Hungary; Department of Anatomy, Medical School, University of Pecs, Pecs, HungaryDepartment of Anesthesiology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States; Department of Clinical Programs, Center of Innovative Research, Banyan Biomarkers, Inc., Alachua, FL, United States (creator_code:org_t)

Related titles

  • In:Journal of Neurotrauma: Mary Ann Liebert29:9, s. 1770-17780897-71511557-9042

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