S100B vs. “GFAP and UCH-L1” assays in the management of mTBI patients
Charlotte Oris, Jean‐Baptiste Bouillon‐Minois, Samy Kahouadji, Bruno Pereira, Gabriel Dhaiby, Valentin Bailly Defrance, Julie Durif, Jeannot Schmidt, Farès Moustafa, Damien Bouvier, Vincent Sapin
Abstract
Abstract Objectives To compare for the first time the performance of “GFAP and UCH-L1” vs. S100B in a cohort of patients managed for mild traumatic brain injury (mTBI) according to actualized French guidelines. Methods A prospective study was recently carried at the Emergency Department of Clermont-Ferrand University Hospital in France. Patients with mTBI presenting a medium risk of complications were enrolled. Blood S100B and “GFAP and UCHL-1” were sampled and measured according to French guidelines. S100B was measured in patients with samples within 3 h of trauma (Cobas ® , Roche Diagnostics), while GFAP and UCHL-1 were measured in all patients (samples <3 h and 3–12 h) using another automated assay (i-STAT ® Alinity, Abbott). Results For sampling <3 h, serum S100B correctly identifies intracranial lesions with a specificity of 25.7 % (95 % CI; 19.5–32.6 %), a sensitivity of 100 % (95 % CI; 66.4–100 %), and a negative predictive value of 100 % (95 % CI; 92.5–100 %). For sampling <12 h, plasma “GFAP and UCH-L1” levels correctly identify intracranial lesions with a specificity of 31.7 % (95 % CI; 25.7–38.2 %), a sensitivity of 100 % (95 % CI; 73.5–100 %), and a negative predictive value of 100 % (95 % CI; 95–100 %). Comparison of specificities (25.7 vs. 31.7 %) did not reveal a statistically significant difference (p=0.16). Conclusions We highlight the usefulness of measuring plasma “GFAP and UCH-L1” levels to target mTBI patients (sampling within 12 h post-injury) and optimize the reduction of CT scans.