Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury Assay
<b>Objectives</b>: To establish age-adjusted cut-off values for glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and assess their impact on the diagnostic performance of the mild traumatic brain injury (mTBI) assay. <b>Methods</b>: T...
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MDPI AG
2025-04-01
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| author | Ivana Lapić Dunja Rogić Matea Bingula Lea Miklić Ivan Gornik |
| author_facet | Ivana Lapić Dunja Rogić Matea Bingula Lea Miklić Ivan Gornik |
| author_sort | Ivana Lapić |
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| description | <b>Objectives</b>: To establish age-adjusted cut-off values for glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and assess their impact on the diagnostic performance of the mild traumatic brain injury (mTBI) assay. <b>Methods</b>: The study included 175 adult mTBI patients presenting at the emergency department (ED) within 12 h from head trauma in whom head CT scan was performed. GFAP and UCH-L1 were measured using chemiluminescence immunoassays on an Abbott analyzer (Abbott Laboratories, USA). <b>Results</b>: Using manufacturer’s defined cut-offs (GFAP < 35 ng/L, UCH-L1 < 400 ng/L), the mTBI assay exhibited diagnostic sensitivity (Se) of 93.1%, specificity (Sp) of 28.8%, negative predictive value (NPV) of 95.5% and a positive predictive value (PPV) of 20.6%. In the subgroup of patients aged under 50, Se and NPV were below 100% (i.e., 75.0% and 92.3%), due to two false negative mTBI results. Age-adjusted cut-offs were defined for three patient groups, ≤49 years, 50–69 years and ≥70 years, and were set to 22.4, 37.0 and 62.3 ng/L for GFAP, and 349.3, 351.6 and 369.0 ng/L for UCH-L1. Using these cut-offs, in all patient groups Se and NPV were 100%, while increased Sp was obtained in patients older than 50 years. <b>Conclusions</b>: Diagnostic Se and NPV can be improved by the use of age-adjusted cut-offs. In this way, the triage protocol for mTBI and head CT scan can be refined, further contributing to the optimization of the diagnostic management of mTBI patients at the ED. |
| format | Article |
| id | doaj-art-6152e79a32fc4cb994822d98d648c1f1 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-6152e79a32fc4cb994822d98d648c1f12025-08-20T03:49:22ZengMDPI AGDiagnostics2075-44182025-04-01159109310.3390/diagnostics15091093Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury AssayIvana Lapić0Dunja Rogić1Matea Bingula2Lea Miklić3Ivan Gornik4Department of Laboratory Diagnostics, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaDepartment of Laboratory Diagnostics, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaDepartment of Emergency Medicine, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaDepartment of Emergency Medicine, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaDepartment of Emergency Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia<b>Objectives</b>: To establish age-adjusted cut-off values for glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and assess their impact on the diagnostic performance of the mild traumatic brain injury (mTBI) assay. <b>Methods</b>: The study included 175 adult mTBI patients presenting at the emergency department (ED) within 12 h from head trauma in whom head CT scan was performed. GFAP and UCH-L1 were measured using chemiluminescence immunoassays on an Abbott analyzer (Abbott Laboratories, USA). <b>Results</b>: Using manufacturer’s defined cut-offs (GFAP < 35 ng/L, UCH-L1 < 400 ng/L), the mTBI assay exhibited diagnostic sensitivity (Se) of 93.1%, specificity (Sp) of 28.8%, negative predictive value (NPV) of 95.5% and a positive predictive value (PPV) of 20.6%. In the subgroup of patients aged under 50, Se and NPV were below 100% (i.e., 75.0% and 92.3%), due to two false negative mTBI results. Age-adjusted cut-offs were defined for three patient groups, ≤49 years, 50–69 years and ≥70 years, and were set to 22.4, 37.0 and 62.3 ng/L for GFAP, and 349.3, 351.6 and 369.0 ng/L for UCH-L1. Using these cut-offs, in all patient groups Se and NPV were 100%, while increased Sp was obtained in patients older than 50 years. <b>Conclusions</b>: Diagnostic Se and NPV can be improved by the use of age-adjusted cut-offs. In this way, the triage protocol for mTBI and head CT scan can be refined, further contributing to the optimization of the diagnostic management of mTBI patients at the ED.https://www.mdpi.com/2075-4418/15/9/1093mild traumatic brain injuryemergency departmentbiomarkerscomputed tomography |
| spellingShingle | Ivana Lapić Dunja Rogić Matea Bingula Lea Miklić Ivan Gornik Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury Assay Diagnostics mild traumatic brain injury emergency department biomarkers computed tomography |
| title | Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury Assay |
| title_full | Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury Assay |
| title_fullStr | Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury Assay |
| title_full_unstemmed | Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury Assay |
| title_short | Age-Adjusted Cut-Off Values for Glial Fibrillary Acidic Protein and Ubiquitin Carboxy-Terminal Hydrolase L1 Improve the Diagnostic Accuracy of the Abbott Mild Traumatic Brain Injury Assay |
| title_sort | age adjusted cut off values for glial fibrillary acidic protein and ubiquitin carboxy terminal hydrolase l1 improve the diagnostic accuracy of the abbott mild traumatic brain injury assay |
| topic | mild traumatic brain injury emergency department biomarkers computed tomography |
| url | https://www.mdpi.com/2075-4418/15/9/1093 |
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