[en] [en] OBJECTIVES: Mild traumatic brain injury (mTBI) remains challenging to diagnose effectively in the emergency department. Abbott has developed the "GFAP/UCH-L1" mTBI test, to guide the clinical decision to perform a computed tomography (CT) head scan by ruling out the presence of mTBI. We evaluated the diagnostic accuracy of the "GFAP/UCH-L1" mTBI test in a Greek cohort and established age-dependent cut-offs.
METHODS: A total of 362 subjects with suspected mTBI and admitted to the Emergency department of the KAT General Hospital of Athens, Greece were recruited for the study. All subjects underwent a CT head scan to establish the diagnosis of mTBI. GFAP and UCH-L1 were measured using Alinity I (Abbott). 163 healthy subjects served as controls.
RESULTS: Using the manufacturer's cut-offs (35 ng/L for GFAP and 400 ng/L for UCH-L1), the "GFAP/UCH-L1" mTBI test had a sensitivity of 99.1 % and a specificity of 40.6 %. However, the specificity dropped to 14.9 % in patients older than 65 years old. By defining a new cut-off of 115 ng/L for GFAP and 335 ng/L specifically for patients older than 65 years, specificity was increased up to 30.6 % without changing test sensitivity and the number of CT head scans avoided was doubled in this subgroup.
CONCLUSIONS: The "GFAP/UCH-L1" mTBI test is an efficient "rule-out test" to exclude patients suffering from mTBI. By adjusting the cut-offs in patients older than 65 years old, we could significantly increase the number of CT head scans avoided without affecting the sensitivity. These new cut-offs should be externally validated.
Research Center/Unit :
CIRM - Centre Interdisciplinaire de Recherche sur le Médicament - ULiège
Disciplines :
Laboratory medicine & medical technology
Author, co-author :
Ladang, Aurélie ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Vavoulis, George; Neurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece
Trifonidi, Ioulia; Clinical Biochemistry Department - KAT General Hospital, Kifissia, Athens, Greece
Calluy, Emma ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Biologie cellulaire et moléculaire
Karagianni, Katerina; Neurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece
Mitropoulos, Athanasios; Neurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece
Vlachos, Konstantinos; Neurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Makris, Konstantinos ; Clinical Biochemistry Department - KAT General Hospital, Kifissia, Athens, Greece
Language :
English
Title :
Increased specificity of the "GFAP/UCH-L1" mTBI rule-out test by age dependent cut-offs.
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