Blood tests can predict which patients are likely to die

Blood tests taken on the day of a traumatic brain injury (TBI) can predict which patients are likely to die or survive with severe disability, allowing clinicians to make decisions earlier on the possible treatment of TBI, says a new study. The findings, published in The Lancet Neurology, revealed that higher values of two protein biomarkers, GFAP and UCH-L1, are associated with death and severe injury.

“Early and accurate prediction of TBI outcomes will help clinicians gauge how severe a brain injury is and inform how best to counsel family members about care for their loved ones with brain injury and what to expect with regards to their recovery," said researcher Frederick Korley from the University of Michigan.

The US Food and Drug Administration (FDA) cleared the use of GFAP and UCH-L1 in 2018 to help clinicians decide whether to order CT scans for mild traumatic brain injury.

For the study, the team measured the proteins using two devices and analyzed day-of-injury blood tests of nearly 1,700 patients with TBI.

Results were compared to evaluations made six months after injury using the Glasgow Outcome Scale-Extended, a system that grades the functional status of TBI patients.

Investigators found that compared to those with GFAP values in the bottom 20th percentile, those with GFAP values in the top 20th percentile had a 23 times higher risk of death during the subsequent six months.

Similarly, compared to those with UCH-L1 values in the bottom 20th percentile, those with UCH-L1 values in the top 20th percentile had a 63 times higher risk of death during the subsequent six months.