ArticleCritical care (London, England)2024
GFAP point-of-care measurement for prehospital diagnosis of intracranial hemorrhage in acute coma.
Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Diagnostic and prognostic value of blood neurofilament light chain in ischemic stroke: an individual patient data meta-analysis.Journal of neurology · 2026Pooled it
- Clinical utility of measuring circulating glial fibrillary acidic protein in severe stroke.Stroke and vascular neurology · 2026Review
- 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 · 2026Article
- Plasma Biomarkers of Brain Injury in Critically Ill Children Receiving Extracorporeal Membrane Oxygenation.JAMA pediatrics · 2026Observational
- Prehospital Detection of Large Vessel Occlusion and Intracerebral Hemorrhage Using a Dual-Biomarker Point-of-Care Test.Stroke (Hoboken, N.J.) · 2026Article
- Predicting intracranial hypertension as a secondary insult using the pathological peptidome of brain injured patients.Scientific reports · 2026Article
- Steric hindrance-mediated extracellular vesicle size fractionation for rapid prehospital diagnosis of intracerebral hemorrhage.Nature communications · 2026Article
- Association of Blood-Based Biomarkers and Malignant Infarction in Severe Anterior Circulation Ischemic Stroke.Brain and behavior · 2026Article
- Astroglial and Neuronal Injury Markers (GFAP, UCHL-1, NfL, Tau, S100B) as Diagnostic and Prognostic Biomarkers in PTSD and Neurological Disorders.International journal of molecular sciences · 2026Review
- Acute care of spontaneous intracerebral hemorrhage.Neurological research and practice · 2025Article
- Review
- A head-to-head comparison of S100B and GFAP/UCH-L1 for detection of traumatic intracranial lesions in a Scandinavian trauma cohort.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Integrating clinical predictors and glial fibrillary acidic protein in prediction models for the prehospital identification of intracerebral haemorrhage in suspected stroke.BMJ neurology open · 2025Article
- Development and internal validation of prehospital prediction models for identifying intracerebral haemorrhage in suspected stroke patients.BMJ neurology open · 2024Article
- Serum glial fibrillary acidic protein in acute stroke: feasibility to determine stroke-type, timeline and tissue-impact.Frontiers in neurology · 2024Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrehospital triage and treatment of patients with acute coma is challenging for rescue services, as the underlying pathological conditions are highly heterogenous. Recently, glial fibrillary acidic protein (GFAP) has been identified as a biomarker of intracranial hemorrhage. The aim of this prospective study was to test whether prehospital GFAP measurements on a point-of-care device have the potential to rapidly differentiate intracranial hemorrhage from other causes of acute coma.
methodsThis study was conducted at the RKH Klinikum Ludwigsburg, a tertiary care hospital in the northern vicinity of Stuttgart, Germany. Patients who were admitted to the emergency department with the prehospital diagnosis of acute coma (Glasgow Coma Scale scores between 3 and 8) were enrolled prospectively. Blood samples were collected in the prehospital phase. Plasma GFAP measurements were performed on the i-STAT Alinity® (Abbott) device (duration of analysis 15 min) shortly after hospital admission.
results143 patients were enrolled (mean age 65 ± 20 years, 42.7% female). GFAP plasma concentrations were strongly elevated in patients with intracranial hemorrhage (n = 51) compared to all other coma etiologies (3352 pg/mL [IQR 613-10001] vs. 43 pg/mL [IQR 29-91.25], p < 0.001). When using an optimal cut-off value of 101 pg/mL, sensitivity for identifying intracranial hemorrhage was 94.1% (specificity 78.9%, positive predictive value 71.6%, negative predictive value 95.9%). In-hospital mortality risk was associated with prehospital GFAP values.
conclusionIncreased GFAP plasma concentrations in patients with acute coma identify intracranial hemorrhage with high diagnostic accuracy. Prehospital GFAP measurements on a point-of-care platform allow rapid stratification according to the underlying cause of coma by rescue services. This could have major impact on triage and management of these critically ill patients.
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