학술논문
Diagnostic performance of point-of-care ubiquitin carboxy-terminal Hydrolase-L1 assay in distinguishing imaging abnormalities in traumatic brain injury: A TRACK-TBI cohort study.
Document Type
Article
Author
Wang, Kevin K.; Munoz-Pareja, Jennifer C.; Lautenslager, Lauren A.; Tyndall, J. Adrian; Zhihui Yang; Kerrigan, Maria R.; Diaz-Arrastia, Ramon; Korley, Frederick K.; Okonkwo, David; Puccio, Ava M.; Yue, John K.; Taylor, Sabrina R.; Mukherjee, Pratik; Yuh, Esther L.; Temkin, Nancy R.; Robertson, Claudia S.; Xiaoying Sun; Jain, Sonia; Markowitz, Amy J.; Manley, Geoffrey T.
Source
Subject
*UBIQUITIN
*BRAIN injuries
*POINT-of-care testing
*BRAIN imaging
*MAGNETIC resonance imaging
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Language
ISSN
2543-1064
Abstract
The use of UCH-L1 detection with point-of-care (POC) assay alone has not been characterized for clinical use. This study compares the accuracies of POC UCH-L1 and Neuron-Specific Enolase (NSE) Elecsys® levels for identifying TBI patients with structural abnormalities on neuroimaging. The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Phase 1 Cohort, enrolled 1375 TBI patients (GCS 3-15) presenting to one of 18 US Level I trauma centers within 24 h of injury who had an admission head CT; blood samples were collected, along with 122 orthopedic and 209 healthy controls. The TBI cohort consisted of 810 CT-negative (CT-) and 549 CT-positive (CT+) subjects. Of the CT-subjects who had MRIs, 121 were MRI-positive (MRI+) and 333 were MRI-negative (MRI-). UCH-L1 POC showed best diagnostic performance for CT + versus CT-, 0-8 h post-injury with an AUC of 0·779 [0·708-0.850] when compared to the 0-25 h interval, with an AUC of 0.684 [0.655-0.712]. NSE assay has an AUC of 0.695 [0.619-0.770] for the 0-8 h interval and 0.634 [0.603-0.665] for the 0-25 h interval. During the first 8 after injury, POC UCH-L1 outperforms NSE in identifying TBI patients with structural abnormalities on neuroimaging. [ABSTRACT FROM AUTHOR]