Evidence map›Paper›PMID 39592246›Full record

ArticleClinical chemistry and laboratory medicine2025

Increased specificity of the "GFAP/UCH-L1" mTBI rule-out test by age dependent cut-offs.

Aurélie Ladang, George Vavoulis, Ioulia Trifonidi, Emma Calluy, Katerina Karagianni, Athanasios Mitropoulos, Konstantinos Vlachos, Etienne Cavalier, Konstantinos Makris

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Article in Clinical chemistry and laboratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

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6citing papers in PubMed
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3 · Its place in the literature

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6 citing papers in PubMed.

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5 · Who and what money

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9 authors.

Aurélie LadangDepartment of Clinical Chemistry, University of Liege, CIRM, Liège, Belgium.ORCID 0000-0002-5316-3108
George VavoulisNeurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece.
Ioulia TrifonidiClinical Biochemistry Department - KAT General Hospital, Kifissia, Athens, Greece.
Emma CalluyDepartment of Clinical Chemistry, University of Liege, CIRM, Liège, Belgium.
Katerina KaragianniNeurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece.
Athanasios MitropoulosNeurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece.
Konstantinos VlachosNeurosurgery Department - KAT General Hospital, Kifissia, Athens, Greece.
Etienne CavalierDepartment of Clinical Chemistry, University of Liege, CIRM, Liège, Belgium.ORCID 0000-0003-0947-2226
Konstantinos MakrisClinical Biochemistry Department - KAT General Hospital, Kifissia, Athens, Greece.ORCID 0000-0002-7896-9028

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMild traumatic brain injury (mTBI) remains challenging to diagnose effectively in the emergency department. Abbott has developed the "GFAP/UCH-L1" mTBI test, to guide the clinical decision to perform a computed tomography (CT) head scan by ruling out the presence of mTBI. We evaluated the diagnostic accuracy of the "GFAP/UCH-L1" mTBI test in a Greek cohort and established age-dependent cut-offs.

methodsA total of 362 subjects with suspected mTBI and admitted to the Emergency department of the KAT General Hospital of Athens, Greece were recruited for the study. All subjects underwent a CT head scan to establish the diagnosis of mTBI. GFAP and UCH-L1 were measured using Alinity I (Abbott). 163 healthy subjects served as controls.

resultsUsing the manufacturer's cut-offs (35 ng/L for GFAP and 400 ng/L for UCH-L1), the "GFAP/UCH-L1" mTBI test had a sensitivity of 99.1 % and a specificity of 40.6 %. However, the specificity dropped to 14.9 % in patients older than 65 years old. By defining a new cut-off of 115 ng/L for GFAP and 335 ng/L specifically for patients older than 65 years, specificity was increased up to 30.6 % without changing test sensitivity and the number of CT head scans avoided was doubled in this subgroup.

conclusionsThe "GFAP/UCH-L1" mTBI test is an efficient "rule-out test" to exclude patients suffering from mTBI. By adjusting the cut-offs in patients older than 65 years old, we could significantly increase the number of CT head scans avoided without affecting the sensitivity. These new cut-offs should be externally validated.

Indexed as

Brain ConcussionGlial Fibrillary Acidic ProteinAdolescentAdultAgedAged, 80 and overAge FactorsFemaleHumansMaleMiddle AgedSensitivity and SpecificityTomography, X-Ray ComputedUbiquitin ThiolesteraseYoung AdultGFAP protein, humanGlial Fibrillary Acidic ProteinUbiquitin ThiolesteraseUCHL1 protein, humanautomated assaybrain concussionglial fibrillary astrocyte protein (GFAP)mild traumatic brain injury (mTBI)ubiquitin carboxyl-terminal hydrolase L-1 (UCH-L1)

Identifiers

PMID39592246

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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.