Observational studyEBioMedicine2024
Association of early blood-based biomarkers and six-month functional outcomes in conventional severity categories of traumatic brain injury: capturing the continuous spectrum of injury.
Observational study in EBioMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Divergent recovery trajectories after mild traumatic brain injury are characterized by distinct acute profiles of neurofilament light, 4R-tau, and white matter diffusivity.Journal of neurology · 2026Article
- Proteomic blood-based biomarkers of brain damage in traumatic brain injury: are they suitable surrogate endpoints for cerebral pressure autoregulatory-guided therapy?Critical care (London, England) · 2026Observational
- Plasma proteome is altered in a piglet model of fetal growth restriction.Scientific reports · 2026Article
- An explainable multimodal machine learning model for diagnosing disorders of consciousness: evidence from a large multicenter Chinese cohort.Journal of translational medicine · 2026Observational
- Serum biomarker trajectory clusters predict functional outcome and quality of life for traumatic brain injury.Brain communications · 2026Article
- Brain age gap as a diffusion MRI-based marker of traumatic brain injury-related brain changes and associated outcomes.Brain communications · 2026Article
- Traumatic brain injury management in the intensive care unit: standard of care and knowledge gaps.Intensive care medicine · 2025Review
- Update on traumatic brain injury in the ICU.Current opinion in anaesthesiology · 2025Review
- Selecting outcome measures to validate prognostic biomarkers of paediatric mild traumatic brain injury: challenges and priorities.Frontiers in neurology · 2025Article
- Sex Differences in Subacute Blood Biomarker Levels and Associations With Post-Concussion Symptom Severity in Adolescents With Concussion.The Journal of head trauma rehabilitationObservational
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTraumatic brain injury is conventionally categorised as mild, moderate, or severe on the Glasgow Coma Scale (GCS). Recently developed biomarkers can provide more objective and nuanced measures of the extent of brain injury.
methodsExposure-response relationships were investigated in 2479 patients aged ≥16 enrolled in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) prospective observational cohort study. Neurofilament protein-light (NFL), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) were assayed from serum sampled in the first 24 h; concentrations were divided into quintiles within GCS severity groups. Relationships with the Glasgow Outcome Scale-Extended were examined using modified Poisson regression including age, sex, major extracranial injury, time to sample, and log biomarker concentration as covariates.
findingsWithin severity groups there were associations between biomarkers and outcomes after adjustment for covariates: GCS 13-15 and negative CT imaging (relative risks [RRs] from 1.28 to 3.72), GCS 13-15 and positive CT (1.21-2.81), GCS 9-12 (1.16-2.02), GCS 3-8 (1.09-1.94). RRs were associated with clinically important differences in expectations of prognosis. In patients with GCS 3 (RRs 1.51-1.80) percentages of unfavourable outcome were 37-51% in the lowest quintiles of biomarker levels and reached 90-94% in the highest quintiles. Similarly, for GCS 15 (RRs 1.83-3.79), the percentages were 2-4% and 19-28% in the lowest and highest biomarker quintiles, respectively.
interpretationConventional TBI severity classification is inadequate and underestimates heterogeneity of brain injury and associated outcomes. The adoption of circulating biomarkers can add to clinical assessment of injury severity.
fundingEuropean Union 7th Framework program (EC grant 602150), Hannelore Kohl Stiftung, One Mind, Integra LifeSciences, Neuro-Trauma Sciences, NIHR Rosetrees Trust.
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