@article{ref1,
title="Biomarkers improve clinical outcome predictors of mortality following non-penetrating severe traumatic brain injury",
journal="Neurocritical care",
year="2014",
author="Papa, Linda and Robertson, Claudia S. and Wang, Kevin K. W. and Brophy, Gretchen M. and Hannay, H. Julia and Heaton, Shelley and Schmalfuss, Ilona and Gabrielli, Andrea and Hayes, Ronald L. and Robicsek, Steven A.",
volume="22",
number="1",
pages="52-64",
abstract="OBJECTIVE: This study assessed whether early levels of biomarkers measured in CSF within 24-h of severe TBI would improve the clinical prediction of 6-months mortality. <br><br>METHODS: This prospective study conducted at two Level 1 Trauma Centers enrolled adults with severe TBI (GCS ≤8) requiring a ventriculostomy as well as control subjects. Ventricular CSF was sampled within 24-h of injury and analyzed for seven candidate biomarkers (UCH-L1, MAP-2, SBDP150, SBDP145, SBDP120, MBP, and S100B). The International Mission on Prognosis and Analysis of Clinical Trials in TBI (IMPACT) scores (Core, Extended, and Lab) were calculated for each patient to determine risk of 6-months mortality. The IMPACT models and biomarkers were assessed alone and in combination. <br><br>RESULTS: There were 152 patients enrolled, 131 TBI patients and 21 control patients. Thirty six (27 %) patients did not survive to 6 months. Biomarkers were all significantly elevated in TBI versus controls (p < 0.001). Peak levels of UCH-L1, SBDP145, MAP-2, and MBP were significantly higher in non-survivors (p < 0.05). Of the seven biomarkers measured at 12-h post-injury MAP-2 (p = 0.004), UCH-L1 (p = 0.024), and MBP (p = 0.037) had significant unadjusted hazard ratios. Of the seven biomarkers measured at the earliest time within 24-h, MAP-2 (p = 0.002), UCH-L1 (p = 0.016), MBP (p = 0.021), and SBDP145 (0.029) had the most significant elevations. When the IMPACT Extended Model was combined with the biomarkers, MAP-2 contributed most significantly to the survival models with sensitivities of 97-100 %. <br><br>CONCLUSIONS: These data suggest that early levels of MAP-2 in combination with clinical data provide enhanced prognostic capabilities for mortality at 6 months.<p /> <p>Language: en</p>",
language="en",
issn="1541-6933",
doi="10.1007/s12028-014-0028-2",
url="http://dx.doi.org/10.1007/s12028-014-0028-2"
}