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.

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“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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