High-Sensitivity Blood Test May Help Rule Out Intracranial Injury

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A combined test of ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein assay results has high sensitivity for detection of intracranial injury among patients with TBI.
A combined test of ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein assay results has high sensitivity for detection of intracranial injury among patients with TBI.

HealthDay News — A combined test of ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) assay results has high sensitivity for detection of intracranial injury among patients with traumatic brain injury (TBI), according to a study published online July 24 in The Lancet Neurology.

Jeffrey J. Bazarian, M.D., from the University of Rochester School of Medicine and Dentistry in New York, and colleagues conducted a prospective observational trial involving adults presenting to emergency departments with suspected, non-penetrating TBI and a Glasgow Coma Scale score of 9 to 15. UCH-L1 and GFAP assay results were combined into a single test result and compared with the results of head computed tomography (CT). A total of 1,977 patients were recruited; 1,959 had analyzable data.

The researchers found that 6 percent of patients had CT-detected intracranial injuries, and less than 1 percent had neurosurgically manageable injuries. Overall, 66 and 34 percent of patients had a positive and negative UCH-L1 and GFAP test result, respectively. The test had a sensitivity of 0.976 and a negative predictive value of 0.996 for detection of intracranial injury. The CT scan was positive when the test was negative in three of 1,959 patients.

"This supports its potential clinical role for ruling out the need for a CT scan among patients with TBI presenting at emergency departments in whom a head CT is felt to be clinically indicated," the authors write.

Several authors disclosed financial ties to diagnostic companies, including Banyan Biomarkers, which sponsored the study.

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