Serum GFAP and UCH-L1 for prediction of absence of intracranial injuries on head CT (ALERT-TBI): a multicentre observational study

Publication date: Available online 24 July 2018Source: The Lancet NeurologyAuthor(s): Jeffrey J Bazarian, Peter Biberthaler, Robert D Welch, Lawrence M Lewis, Pal Barzo, Viktoria Bogner-Flatz, P Gunnar Brolinson, Andras Büki, James Y Chen, Robert H Christenson, Dallas Hack, J Stephen Huff, Sandeep Johar, J Dedrick Jordan, Bernd A Leidel, Tobias Lindner, Elizabeth Ludington, David O Okonkwo, Joseph Ornato, W Frank PeacockSummaryBackgroundMore than 50 million people worldwide sustain a traumatic brain injury (TBI) annually. Detection of intracranial injuries relies on head CT, which is overused and resource intensive. Blood-based brain biomarkers hold the potential to predict absence of intracranial injury and thus reduce unnecessary head CT scanning. We sought to validate a test combining ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP), at predetermined cutoff values, to predict traumatic intracranial injuries on head CT scan acutely after TBI.MethodsThis prospective, multicentre observational trial included adults (≥18 years) presenting to participating emergency departments with suspected, non-penetrating TBI and a Glasgow Coma Scale score of 9–15. Patients were eligible if they had undergone head CT as part of standard emergency care and blood collection within 12 h of injury. UCH-L1 and GFAP were measured in serum and analysed using prespecified cutoff values of 327 pg/mL and 22 pg/mL, respectively. UCH-L1 and GFAP assay results w...
Source: The Lancet Neurology - Category: Neurology Source Type: research