The following is a summary of “A high-performance core laboratory GFAP/UCH-L1 test for the prediction of intracranial injury after mild traumatic brain injury,” published in the March 2025 issue of American Journal of Emergency Medicine by Welch et al. 

A Food and Drug Administration (FDA)-cleared glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) blood biomarker panel was shown to reliably eliminate the need for head computed tomography (CT) scans in select individuals with traumatic brain injury (TBI), using either a core laboratory or point-of-care platform.  

Researchers conducted a retrospective study to evaluate the test characteristics of the panel using a core lab-based fast, high-throughput platform.  

They performed a secondary analysis using clinical data and banked blood samples from the ALERT-TBI study, including individuals aged 18 years or older with nonpenetrating head injury, a Glasgow Coma Scale score of 9–15 at presentation, and a head CT scan requirement. Those with a GCS score of 13–15 was included if they had sufficient banked blood for analysis. The test characteristics of the biomarker panel were assessed in relation to head CT findings for TBI.  

The results showed that among the 1,899 included individuals, the mean age was 49.1 years (18 to 98 years), with 56.5% identified as male and 70.6% as Caucasian. Falls were the most common cause of injury (51.9%), and 94.1% had a Glasgow Coma Scale score of 15 at presentation. Head CT detected 120 individuals with traumatic intracranial injury (6.3%), with the biomarker panel yielding 4 false-negative results. The sensitivity of the biomarker panel was 96.7% (95% confidence interval: 91.7, 98.7), specificity was 40.1% (37.8, 42.4), negative predictive value was 99.4% (98.6, 99.8), and the negative likelihood ratio was 0.08 (0.03, 0.22).  

Investigators concluded that the biomarker panel, when estimated on the rapid, high-throughput core laboratory platform, showed high sensitivity and negative predictive values, offering potential benefits in scenarios with substantial CT imaging demands like mass casualties or emergency department overcrowding due to its speed and capacity for simultaneous multi-sample analysis. 

Source: sciencedirect.com/science/article/abs/pii/S0735675724006880