TY  - JOUR
AU  - Lagerstedt, Linnéa
A2  - Lagerstedt, Linnéa
A2  - Egea-Guerrero, Juan José
A2  - Bustamante, Alejandro
A2  - Rodríguez-Rodríguez, Ana
A2  - El Rahal, Amir
A2  - Quintana-Diaz, Manuel
A2  - García-Armengol, Roser
A2  - Prica, Carmen Melinda
A2  - Andereggen, Elisabeth
A2  - Rinaldi, Lara
A2  - Sarrafzadeh, Asita
A2  - Schaller, Karl
A2  - Montaner, Joan
A2  - Sanchez, Jean-Charles
DB  - BISp
DP  - BISp
KW  - Computertomographie
KW  - Diagnostische Verfahren
KW  - Gehirn
KW  - Gehirnerschütterung
KW  - Hirnfunktion
KW  - Hirnverletzung
KW  - Leistungsbeeinflussung
KW  - Markersubstanz
KW  - Neurophysiologie
KW  - Neuropsychologie
KW  - Schädelhirnverletzung
KW  - Sportmedizin
KW  - Sporttraumatologie
KW  - Zentralnervensystem
LA  - eng
TI  - Combining H-FABP and GFAP increases the capacity to differentiate between CT-positive and CT-negative patients with mild traumatic brain injury
TT  - Die Kombination von H-FABP und GFAP erhöht die Fähigkeit, zwischen CT-positiven und CT-negativen Patienten mit leichter traumatischer Hirnverletzung zu differenzieren
PY  - 2018
N2  - Mild traumatic brain injury (mTBI) patients may have trauma-induced brain lesions detectable using CT scans. However, most patients will be CT-negative. There is thus a need for an additional tool to detect patients at risk. Single blood biomarkers, such as S100B and GFAP, have been widely studied in mTBI patients, but to date, none seems to perform well enough. In many different diseases, combining several biomarkers into panels has become increasingly interesting for diagnoses and to enhance classification performance. The present study evaluated 13 proteins individually—H-FABP, MMP-1, MMP-3, MMP-9, VCAM, ICAM, SAA, CRP, GSTP, NKDA, PRDX1, DJ-1 and IL-10—for their capacity to differentiate between patients with and without a brain lesion according to CT results. The best performing proteins were then compared and combined with the S100B and GFAP proteins into a CT-scan triage panel. Patients diagnosed with mTBI, with a Glasgow Coma Scale score of 15 and one additional clinical symptom were enrolled at three different European sites. A blood sample was collected at hospital admission, and a CT scan was performed. Patients were divided into two two-centre cohorts and further dichotomised into CT-positive and CT-negative groups for statistical analysis. Single markers and panels were evaluated using Cohort 1. Four proteins—H-FABP, IL-10, S100B and GFAP—showed significantly higher levels in CT-positive patients. The best-performing biomarker was H-FABP, with a specificity of 32% (95% CI 23–40) and sensitivity reaching 100%. The best-performing two-marker panel for Cohort 1, subsequently validated in Cohort 2, was a combination of H-FABP and GFAP, enhancing specificity to 46% (95% CI 36–55). When adding IL-10 to this panel, specificity reached 52% (95% CI 43–61) with 100% sensitivity. These results showed that proteins combined into panels could be used to efficiently classify CT-positive and CT-negative mTBI patients.
L2  - http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200394
L2  - https://dx.doi.org/10.1371/journal.pone.0200394
DO  - 10.1371/journal.pone.0200394
SP  - Art.-ID e0200394, [13 S.]
SN  - 1932-6203
JO  - PLoS one / Public Library of Science
IS  - 7
VL  - 13
M3  - Elektronische Ressource (online)
ID  - PU201808005448
ER  -