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Blood tests taken within 24 hours of a traumatic brain injury can predict whether a patient will die, or survive with serious disability

Published on 12/08/22 at 10:27am

The tests’ results are available within minutes and will be useful in helping trauma ward staff and surgeons to decide the best treatment for a patient with a traumatic brain injury (TBI), whether that’s immediate surgical interventions, or simply how to guide a conversation with the patient’s family.

 

GFAP and UCH-L1 are two protein biomarkers which correlate to the severity of a TBI. The authors of the study, which was published in The Lancet Neurology on 10 August 2022, purport that high values of these biomarkers indicate death and severe injury.

 

The tests were originally cleared by the FDA in 2018 for use in determining which patients with mild TBI should undergo CT scans.

 

Researchers from TRACK-TBI, a University of California, San Francisco (UCSF)-led brain injury research initiative, used the Abbot i-STAT Alinity (a portable blood analyser) and ACHITECT assays to examine the day-of-injury blood tests of 1,696 patients with TBI. They then used the Glasgow Outcome Scale Extended, which grades outcomes and quantifies levels of disability following TBI, to compare these results to the patients’ six-month assessments.

 

Outcomes range from level I (death) to level VIII (complete recovery with resumption to normal life but minor deficits in some cases). Patients had been evaluated at eighteen level I trauma centres, and at six months post-injury, 7% had died and 14% had an ‘unfavourable outcome’, with Level II – IV injuries ranging from vegetative states to severe disability requiring daily support. The remaining 67% had ‘incomplete recovery’.

 

Researchers found that the day-of-injury blood tests had a high probability of predicting death (87% for GFAP and 89% for UCH-L1) and severe disability (86% GFAP and UCH-L1) at six months.

 

Co-senior author of the study Geoffrey Manley (MD, PhD, professor and Vice Chair of Neurosurgery at UCSF) stated: “We believe this tool may encourage clinicians to be more aggressive in their decisions to begin or continue life-saving treatment,” especially in “mass casualty situations where they may play a critical role in triage and resource allocation.”

 

James Spargo

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