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The following is a summary of “Evaluation of GFAP/UCH-L1 biomarkers for computed tomography exclusion in mild traumatic brain injury (mTBI),” published in the October 2024 issue of Emergency Medicine by Legramante et al. 

Mild traumatic brain injury (mTBI), a significant public health concern, is diagnosed by clinical assessment and computed tomography (CT) scans, while glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase-L1 (UCH-L1) explored as potential biomarkers.  

Researchers conducted a retrospective study to evaluate the combined use of GFAP and UCH-L1 as the negative predictors to rule out brain injuries in patients with mTBI.  

They included adult participants (n = 130) enrolled at Tor Vergata University Hospital (Rome, Italy), who consecutively presented at the emergency department triage between October 2022 and January 2023 with non-penetrating TBI and a Glasgow Coma Scale (GCS) score of 13–15. All eligible participants underwent intracranial CT scans and blood tests within 12 hours post-trauma to measure serum levels of GFAP and UCH-L1.  

The results showed that intracranial CT detected injuries in 7 patients (5%) only. The GFAP and UCH-L1 tests were positive in 96 patients and negative in 34 patients (74% vs 26%). The combined biomarkers had a sensitivity of 1.00 (95% CI 0.64-1.00) and a negative predictive value (NPV) of 1.00 (0.99-1.00) in diagnosing mTBI with a negative CT.  

They concluded the combined laboratory tests for GFAP and UCH-L1 biomarkers could reduce unnecessary head CT scans in patients with suspected mTBI in emergency departments.   

Source: intjem.biomedcentral.com/articles/10.1186/s12245-024-00708-z