In study, method predicted poor outcome six months after injury with high accuracy – Psychology and Psychiatry News

Blood tests done on the day of traumatic brain injury can predict which patients with severe disability are likely to die or survive, allowing doctors to make earlier decisions about potential treatment for TBI, the study finds.

Researchers from Michigan Medicine, the University of California, San Francisco and the University of Pennsylvania analyzed day-of-injury blood tests from nearly 1,700 patients with TBI. Results published in The Lancet Neurology show that higher levels of two protein biomarkers, GFAP and UCH-L1, are associated with death and serious injury.

This is the first study to examine the association between biomarker levels of these two proteins and all-cause mortality after TBI, says first author Frederick Korley, MD, Ph.D., associate professor of medicine in the emergency department at the University of Michigan Medical School .

“Early and accurate prediction of TBI outcomes will help physicians assess the severity of a brain injury and how best to advise family members on what and how to care for loved ones with brain injuries as they work toward their recovery,” he said Korley. “It will also help researchers more precisely target promising TBI therapies to the right TBI patients. »

The United States Food and Drug Administration approved the use of GFAP and UCH-L1 in 2018 to help physicians decide whether or not to order CT scans for mild traumatic brain injuries.

The researchers measured the proteins using two Abbott Laboratories devices, the i-STAT Alinity and the ARCHITECT. The results were compared to assessments conducted six months after injury using the Glasgow Outcome Scale-Extended, a system that assesses the functional status of TBI patients.

Investigators found that those with GFAP levels in the upper 20th percentile had a 23-fold increased risk of dying in the next six months compared to those with GFAP levels in the lower 20th percentile. Likewise, those with UCH-L1 levels in the upper 20th percentile had a 63-fold increased risk of death over the next 6 months compared to those with UCH-L1 levels in the lower 20th percentile.

“Modern trauma care can work well for injuries that we once thought were non-survivable,” said co-senior author Geoffrey Manley, MD, Ph.D., professor and vice chair of neurosurgery at UCSF. “These blood tests are both diagnostic and prognostic, easy to perform, safe and inexpensive. »

While the method shows promise for determining poor outcomes in moderate and severe CBT, the researchers say more needs to be done to examine its role in mild cases.

“As a next step, the TRACK-TBI team is planning a clinical trial that will examine the efficacy of promising therapeutic agents that may help patients with traumatic brain injuries recover quickly,” said Korley. “In this clinical study, these biomarkers will be used as an objective method to select the right patients to participate in this study. We will also use these biomarkers to monitor individual patient responses to these promising therapies.

Korley was previously a consultant for Abbott Laboratories. Korley and Robertson received research grants from Abbott Laboratories. Manley received research funding from a collaboration between Abbott Laboratories and the US Department of Defense. Diaz-Arrastia advised on MesoScale Discoveries, BrainBox Solutions and NovaSignal. All other authors and contributors declare no competing interests.

Source of the story:

Materials provided by Michigan Medicine – University of Michigan. Originally written by Noah Fromson. Note: Content can be edited for style and length.

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