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J Neurotrauma. 2018 Nov 29. doi: 10.1089/neu.2018.5952. [Epub ahead of print]

<b>Early levels of GFAP and NF-L in predicting the outcome of mild TBI</b>.

Author information

1
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurosurgery, Turku, Finland ; ifthos@utu.fi.
2
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurology, Turku, Finland ; mehmoh@utu.fi.
3
University of Turku and Turku University Hospital, Perioperative Services, Intensive Care Medicine and Pain Management, Turku, Finland ; riikka.takala@gmail.com.
4
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurology, Turku, Finland ; olli.tenovuo@tyks.fi.
5
University of Geneva, Department of Human protein science, Geneva, Switzerland ; linnea.lagerstedt@unige.ch.
6
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurology, Turku, Finland ; hmalse@utu.fi.
7
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurosurgery, Turku, Finland ; janek.frantzen@tyks.fi.
8
VTT Technical Research Centre of Finland, Systems Medicine, Tampere, Finland ; Mark.vanGils@vtt.fi.
9
University of Cambridge and Addenbrooke's Hospital, Department of Clinical Neurosciences, Neurosurgery Unit, Cambridge, United Kingdom of Great Britain and Northern Ireland ; pjah2@cam.ac.uk.
10
University of Turku and Turku University Hospital, Perioperative Services, Intensive Care Medicine and Pain Management, Turku, Finland ; ajkatila@gmail.com.
11
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurosurgery, Turku, Finland ; hrmaan@utu.fi.
12
University of Cambridge and Addenbrooke's Hospital, Division of Anaesthesia, Cambridge, United Kingdom of Great Britain and Northern Ireland ; dkm13@cam.ac.uk.
13
University of Cambridge and Addenbrooke's Hospital, Division of Anaesthesia, Cambridge, United Kingdom of Great Britain and Northern Ireland ; vfjn2@cam.ac.uk.
14
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurology, Turku, Finland ; jptall@utu.fi.
15
Quanterix Corp, 299024, Cambridge, Massachusetts, United States ; khrusovsky@quanterix.com.
16
Quanterix Corp, Cambridge, Massachusetts, United States ; dwilson@quanterix.com.
17
The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Gothenburg, Sweden ; kaj.blennow@neuro.gu.se.
18
University of Geneva, Department of Human Protein Sciences, Geneva, Switzerland ; jean-charles.sanchez@unige.ch.
19
The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Gothenburg, Sweden ; henrik.zetterberg@clinchem.gu.se.
20
University of Turku and Turku University Hospital, Division of Clinical Neurosciences, Department of Neurosurgery, Turku, Finland ; jussi.posti@utu.fi.

Abstract

To correlate the early levels of glial fibrillary acidic protein (GFAP) and neurofilament light protein (NF-L) with outcome in patients with mild traumatic brain injury (mTBI). 107 patients with mTBI [Glasgow Coma Scale (GCS) ≥13] having the blood samples for GFAP and NF-L available within 24 hrs from arrival were included. Patients with mTBI were divided into computed tomography (CT)-positive and CT-negative groups. Glasgow Outcome Scale extended (GOSE) was used to assess the outcome. Outcomes were defined as complete (GOSE 8) vs. incomplete (GOSE <8), and favorable (GOSE 5-8) vs. unfavorable (GOSE 1-4). GFAP and NF-L concentrations in blood were measured using ultrasensitive single molecule array technology. Patients with incomplete recovery had significantly higher levels of NF-L compared to those with complete recovery (p=0.005). The levels of GFAP and NF-L were significantly higher in patients with unfavorable outcome than in patients with favorable outcome (p=0.002 for GFAP and p <0.001 for NF-L). For predicting favorable outcome, the area under the ROC curve for GFAP and NF-L was 0.755 and 0.826, respectively. In a multivariate logistic regression model, the level of NF-L was still a significant predictor for complete recovery (OR=1.008, 95%CI, 1.000-1.016). Moreover, the level of NF-L was a significant predictor for complete recovery in CT-positive patients (OR=1.009, 95%CI, 1.001-1.016). The early levels of GFAP and NF-L are significantly correlated with the outcome in patients with mTBI. The level of NF-L within 24 hrs from arrival has a significant predictive value in mTBI also in a multivariate model.

KEYWORDS:

BIOMARKERS; OUTCOME MEASURES; TRAUMATIC BRAIN INJURY

PMID:
30489229
DOI:
10.1089/neu.2018.5952

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