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Sökning: WFRF:(Center J R) > (2020-2024) > Serum biomarkers id...

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FältnamnIndikatorerMetadata
00008724naa a2200793 4500
001oai:DiVA.org:oru-102533
003SwePub
008221205s2022 | |||||||||||000 ||eng|
009oai:lup.lub.lu.se:1fde7302-50ba-40b1-9acd-90eb1b2ed5fa
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-1025332 URI
0247 a https://doi.org/10.1186/s13054-022-04250-32 DOI
0247 a https://lup.lub.lu.se/record/1fde7302-50ba-40b1-9acd-90eb1b2ed5fa2 URI
040 a (SwePub)orud (SwePub)lu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Richter, Sophieu University Division of Anaesthesia, University of Cambridge, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK4 aut
2451 0a Serum biomarkers identify critically ill traumatic brain injury patients for MRI
264 c 2022-11-29
264 1b BioMed Central (BMC),c 2022
338 a print2 rdacarrier
500 a Funding agencies:Hannelore Kohl Stiftung (Germany)OneMind (USA)Integra LifeSciences Corporation (USA)NeuroTrauma Sciences (USA)National Institute for Health Research (NIHR)Academy of Medical Sciences/The Health Foundation (UK) 
520 a BACKGROUND: Magnetic resonance imaging (MRI) carries prognostic importance after traumatic brain injury (TBI), especially when computed tomography (CT) fails to fully explain the level of unconsciousness. However, in critically ill patients, the risk of deterioration during transfer needs to be balanced against the benefit of detecting prognostically relevant information on MRI. We therefore aimed to assess if day of injury serum protein biomarkers could identify critically ill TBI patients in whom the risks of transfer are compensated by the likelihood of detecting management-altering neuroimaging findings.METHODS: Data were obtained from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Eligibility criteria included: TBI patients aged ≥ 16 years, Glasgow Coma Score (GCS) < 13 or patient intubated with unrecorded pre-intubation GCS, CT with Marshall score < 3, serum biomarkers (GFAP, NFL, NSE, S100B, Tau, UCH-L1) sampled ≤ 24 h of injury, MRI < 30 days of injury. The degree of axonal injury on MRI was graded using the Adams-Gentry classification. The association between serum concentrations of biomarkers and Adams-Gentry stage was assessed and the optimum threshold concentration identified, assuming different minimum sensitivities for the detection of brainstem injury (Adams-Gentry stage 3). A cost-benefit analysis for the USA and UK health care settings was also performed. RESULTS: Among 65 included patients (30 moderate-severe, 35 unrecorded) axonal injury was detected in 54 (83%) and brainstem involvement in 33 (51%). In patients with moderate-severe TBI, brainstem injury was associated with higher concentrations of NSE, Tau, UCH-L1 and GFAP. If the clinician did not want to miss any brainstem injury, NSE could have avoided MRI transfers in up to 20% of patients. If a 94% sensitivity was accepted considering potential transfer-related complications, GFAP could have avoided 30% of transfers. There was no added net cost, with savings up to £99 (UK) or $612 (US). No associations between proteins and axonal injury were found in intubated patients without a recorded pre-intubation GCS.CONCLUSIONS: Serum protein biomarkers show potential to safely reduce the number of transfers to MRI in critically ill patients with moderate-severe TBI at no added cost.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Medicinska och farmaceutiska grundvetenskaperx Neurovetenskaper0 (SwePub)301052 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Basic Medicinex Neurosciences0 (SwePub)301052 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Neurologi0 (SwePub)302072 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Neurology0 (SwePub)302072 hsv//eng
653 a Diffuse axonal injury
653 a Glasgow Coma Scale
653 a Glial fibrillary acidic protein (GFAP)
653 a Magnetic resonance imaging
653 a Neuron-specific enolase (NSE)
653 a Serum protein biomarkers
653 a Tau
653 a Traumatic axonal injury
653 a Traumatic brain injury
653 a Ubiquitin C terminal hydrolase L1 (UCH-L1)
653 a Diffuse axonal injury
653 a Glasgow Coma Scale
653 a Glial fibrillary acidic protein (GFAP)
653 a Magnetic resonance imaging
653 a Neuron-specific enolase (NSE)
653 a Serum protein biomarkers
653 a Tau
653 a Traumatic axonal injury
653 a Traumatic brain injury
653 a Ubiquitin C terminal hydrolase L1 (UCH-L1)
7001 a Winzeck, Stefanu University Division of Anaesthesia, University of Cambridge, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK; Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, UK4 aut
7001 a Czeiter, Endreu Department of Neurosurgery, Medical School, University of Pécs, Pecs, Hungary; Neurotrauma Research Group, Szentágothai Research Centre, University of Pécs, Pecs, Hungary; ELKH-PTE Clinical Neuroscience MR Research Group, University of Pécs, Pecs, Hungary4 aut
7001 a Amrein, Krisztinau Department of Neurosurgery, Medical School, University of Pécs, Pecs, Hungary; Neurotrauma Research Group, Szentágothai Research Centre, University of Pécs, Pecs, Hungary; ELKH-PTE Clinical Neuroscience MR Research Group, University of Pécs, Pecs, Hungary4 aut
7001 a Kornaropoulos, Evgenios N.u Lund University,Lunds universitet,Diagnostisk radiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Diagnostic Radiology, (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine4 aut0 (Swepub:lu)ev2115ko
7001 a Verheyden, Janu Research and Development, icometrix, Leuven, Belgium4 aut
7001 a Sugar, Gabrielau Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA, USA4 aut
7001 a Yang, Zhihuiu Program for Neurotrauma, Neuroproteomics and Biomarker Research, Departments of Emergency Medicine, Psychiatry and Neuroscience, University of Florida, Gainesville, USA4 aut
7001 a Wang, Kevinu Program for Neurotrauma, Neuroproteomics and Biomarker Research, Departments of Emergency Medicine, Psychiatry and Neuroscience, University of Florida, Gainesville, USA4 aut
7001 a Maas, Andrew I. R.u Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium4 aut
7001 a Steyerberg, Ewoutu Department of Biomedical Data Sciences, University Medical Centre, Leiden, Netherlands4 aut
7001 a Büki, Andras,d 1966-u Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Neurosurgery, Medical School, University of Pécs, Pecs, Hungary; Neurotrauma Research Group, Szentágothai Research Centre, University of Pécs, Pecs, Hungary; Department of Neurosurgery, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden4 aut0 (Swepub:oru)asbi
7001 a Newcombe, Virginia F Ju University Division of Anaesthesia, University of Cambridge, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK4 aut
7001 a Menon, David K.u University Division of Anaesthesia, University of Cambridge, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK4 aut
7001 a Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Magnetic Resonance Imaging (CENTER-TBI MRI) Sub-study Participants and Investigators, -4 ctb
7102 a University Division of Anaesthesia, University of Cambridge, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UKb University Division of Anaesthesia, University of Cambridge, Box 93, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK; Biomedical Image Analysis Group, Department of Computing, Imperial College London, London, UK4 org
7730 t Critical Cared : BioMed Central (BMC)g 26:1q 26:1x 1364-8535x 1466-609X
8564 u https://doi.org/10.1186/s13054-022-04250-3y Fulltext
8564 u http://dx.doi.org/10.1186/s13054-022-04250-3x freey FULLTEXT
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-102533
8564 8u https://doi.org/10.1186/s13054-022-04250-3
8564 8u https://lup.lub.lu.se/record/1fde7302-50ba-40b1-9acd-90eb1b2ed5fa

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