Evidence map›Paper›PMID 38251868›Full record

ArticleJournal of neurotrauma2024

Diagnostic Utility of Glial Fibrillary Acidic Protein Beyond 12 Hours After Traumatic Brain Injury: A TRACK-TBI Study.

Ava M Puccio, John K Yue, Frederick K Korley, David O Okonkwo, Ramon Diaz-Arrastia, Esther L Yuh, Adam R Ferguson, Pratik Mukherjee, Kevin K W Wang, Sabrina R Taylor and 5 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurotrauma, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Impact of routine use of the GFAP and UCH-L1 TBI blood test for management of mild TBI on patient care in a European emergency department.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
  3. Article
  4. Article
  5. Article
  6. New insights into metabolism dysregulation after TBI.Journal of neuroinflammation · 2024
    Review
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 6 institutions in 1 country.

Ava M PuccioDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
John K YueDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Frederick K KorleyDepartment of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.
David O OkonkwoDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Ramon Diaz-ArrastiaDepartment of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Esther L YuhBrain and Spinal Injury Center, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA.
Adam R FergusonDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Pratik MukherjeeBrain and Spinal Injury Center, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA.
Kevin K W WangCenter for Neurotrauma, Multiomics and Biomarkers, Morehouse School of Medicine, Atlanta, Georgia, USA.
Sabrina R TaylorDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Hansen DengDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Amy J MarkowitzDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Xiaoying SunBiostatistics Research Center, Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, San Diego, California, USA.
Sonia JainBiostatistics Research Center, Herbert Wertheim School of Public Health and Longevity Science, University of California San Diego, San Diego, California, USA.
Geoffrey T ManleyDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
San Francisco General Hospital · USUniversity of Pittsburgh Medical Center · USHuman Longevity (United States) · USMorehouse School of Medicine · USUniversity of Michigan · USUniversity of Pennsylvania · US

Funding

Transforming Research and Clinical Knowledge in Traumatic Brain InjuryU01NS086090 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI DIAZ-ARRASTIA, RAMON, GIACINO, JOSEPH THOMAS · 2013 to 2017
$19.1M
Transforming Traumatic Brain Injury Research and Clinical CareRC2NS069409 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MANLEY, GEOFFREY T · 2009 to 2011
$4.3M
NINDS NIH HHS RC2 NS069409NINDS NIH HHS U01 NS086090
6 · The paper itself

Abstract

Blood levels of glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase-L1 (UCH-L1) within 12h of suspected traumatic brain injury (TBI) have been approved by the Food and Drug administration to aid in determining the need for a brain computed tomography (CT) scan. The current study aimed to determine whether this context of use can be expanded beyond 12h post-TBI in patients presenting with Glasgow Coma Scale (GCS) 13-15. The prospective, 18-center Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study enrolled TBI participants aged ≥17 years who presented to a United States Level 1 trauma center and received a clinically indicated brain CT scan within 24h post-injury, a blood draw within 24h and at 14 days for biomarker analysis. Data from participants with emergency department arrival GCS 13-15 and biomarker values at days 1 and 14 were extracted for the primary analysis. A subgroup of hospitalized participants with serial biomarkers at days 1, 3, 5, and 14 were analyzed, including plasma GFAP and UCH-L1, and serum neuron-specific enolase (NSE) and S100 calcium-binding protein B (S100B). The primary analysis compared biomarker values dichotomized by head CT results (CT+/CT-). Area under receiver-operating characteristic curve (AUC) was used to determine diagnostic accuracy. The overall cohort included 1142 participants with initial GCS 13-15, with mean age 39.8 years, 65% male, and 73% Caucasian. The GFAP provided good discrimination in the overall cohort at days 1 (AUC = 0.82) and 14 (AUC = 0.72), and in the hospitalized subgroup at days 1 (AUC = 0.84), 3 (AUC = 0.88), 5 (AUC = 0.82), and 14 (AUC = 0.74). The UCH-L1, NSE, and S100B did not perform well (AUC = 0.51-0.57 across time points). This study demonstrates the utility of GFAP to aid in decision-making for diagnostic brain CT imaging beyond the 12h time frame in patients with TBI who have a GCS 13-15.

Indexed as

BiomarkersBrain Injuries, TraumaticGlial Fibrillary Acidic ProteinUbiquitin ThiolesteraseAdultAgedFemaleGlasgow Coma ScaleHumansMaleMiddle AgedProspective StudiesTime FactorsTomography, X-Ray ComputedYoung AdultBiomarkersGFAP protein, humanGlial Fibrillary Acidic ProteinUbiquitin ThiolesteraseUCHL1 protein, humanbiomarkerdiagnosisglial fibrillary acidic proteinmedical decision-makingneuroimagingpoint-of-care testingtraumatic brain injury

Identifiers

PMID38251868
PMCPMC11564837
OpenAlexW4391103092

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.