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

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aut.relation.articlenumber105298
aut.relation.endpage105298
aut.relation.journaleBioMedicine
aut.relation.startpage105298
aut.relation.volume107
dc.contributor.authorWilson, L
dc.contributor.authorNewcombe, VFJ
dc.contributor.authorWhitehouse, DP
dc.contributor.authorMondello, S
dc.contributor.authorMaas, AIR
dc.contributor.authorMenon, DK
dc.contributor.authorAckerlund, C
dc.contributor.authorAmrein, K
dc.contributor.authorAndelic, N
dc.contributor.authorAndreassen, L
dc.contributor.authorAnke, A
dc.contributor.authorAntoni, A
dc.contributor.authorAudibert, G
dc.contributor.authorAzouvi, P
dc.contributor.authorAzzolini, ML
dc.contributor.authorBartels, R
dc.contributor.authorBarzó, P
dc.contributor.authorBeauvais, R
dc.contributor.authorBeer, R
dc.contributor.authorBellander, BM
dc.contributor.authorBelli, A
dc.contributor.authorBenali, H
dc.contributor.authorBerardino, M
dc.contributor.authorBeretta, L
dc.contributor.authorBlaabjerg, M
dc.contributor.authorBragge, P
dc.contributor.authorBrazinova, A
dc.contributor.authorBrinck, V
dc.contributor.authorBrooker, J
dc.contributor.authorBrorsson, C
dc.contributor.authorBuki, A
dc.contributor.authorBullinger, M
dc.contributor.authorCabeleira, M
dc.contributor.authorCaccioppola, A
dc.contributor.authorCalappi, E
dc.contributor.authorCalvi, MR
dc.contributor.authorCameron, P
dc.contributor.authorLozano, GC
dc.contributor.authorCarbonara, M
dc.contributor.authorCastaño-León, AM
dc.contributor.authorCavallo, S
dc.contributor.authorChevallard, G
dc.contributor.authorChieregato, A
dc.contributor.authorCiterio, G
dc.contributor.authorClusmann, H
dc.contributor.authorCoburn, MS
dc.contributor.authorColes, J
dc.contributor.authorCooper, JD
dc.contributor.authorCorreia, M
dc.contributor.authorČović, A
dc.contributor.authorCurry, N
dc.contributor.authorCzeiter, E
dc.contributor.authorCzosnyka, M
dc.contributor.authorDahyot-Fizelier, C
dc.contributor.authorDark, P
dc.contributor.authorDawes, H
dc.contributor.authorDe Keyser, V
dc.contributor.authorDegos, V
dc.contributor.authorDella Corte, F
dc.contributor.authorBoogert, HD
dc.contributor.authorDepreitere, B
dc.contributor.authorĐilvesi, Đ
dc.contributor.authorDixit, A
dc.contributor.authorDonoghue, E
dc.contributor.authorDreier, J
dc.contributor.authorDulière, GL
dc.contributor.authorErcole, A
dc.contributor.authorEsser, P
dc.contributor.authorEzer, E
dc.contributor.authorFabricius, M
dc.contributor.authorFeigin, VL
dc.contributor.authorFoks, K
dc.contributor.authorFrisvold, S
dc.contributor.authorFurmanov, A
dc.contributor.authorGagliardo, P
dc.contributor.authorGalanaud, D
dc.contributor.authorGantner, D
dc.contributor.authorGao, G
dc.contributor.authorGeorge, P
dc.contributor.authorGhuysen, A
dc.contributor.authorGiga, L
dc.contributor.authorGlocker, B
dc.contributor.authorGolubović, J
dc.contributor.authorGomez, PA
dc.contributor.authorGratz, J
dc.contributor.authorGravesteijn, B
dc.contributor.authorGrossi, F
dc.contributor.authorGruen, RL
dc.contributor.authorGupta, D
dc.contributor.authorHaagsma, JA
dc.contributor.authorHaitsma, I
dc.contributor.authorHelbok, R
dc.contributor.authorHelseth, E
dc.contributor.authorHorton, L
dc.contributor.authorHuijben, J
dc.contributor.authorHutchinson, PJ
dc.contributor.authorJacobs, B
dc.contributor.authorJankowski, S
dc.contributor.authorJarrett, M
dc.contributor.authorJiang, JY
dc.date.accessioned2024-09-03T23:16:50Z
dc.date.available2024-09-03T23:16:50Z
dc.date.issued2024
dc.description.abstractBackground: Traumatic 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. Methods: Exposure–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. Findings: Within 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. Interpretation: Conventional 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. Funding: European Union 7th Framework program (EC grant 602150), Hannelore Kohl Stiftung, One Mind, Integra LifeSciences, Neuro-Trauma Sciences, NIHR Rosetrees Trust.
dc.identifier.citationeBioMedicine, ISSN: 2352-3964 (Print); 2352-3964 (Online), Elsevier BV, 107, 105298-105298. doi: 10.1016/j.ebiom.2024.105298
dc.identifier.doi10.1016/j.ebiom.2024.105298
dc.identifier.issn2352-3964
dc.identifier.issn2352-3964
dc.identifier.urihttp://hdl.handle.net/10292/17971
dc.languageen
dc.publisherElsevier BV
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S2352396424003347
dc.rights© 2024 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
dc.rights.accessrightsOpenAccess
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject1103 Clinical Sciences
dc.subject1117 Public Health and Health Services
dc.subject3202 Clinical sciences
dc.subject4202 Epidemiology
dc.titleAssociation of Early Blood-Based Biomarkers and Six-Month Functional Outcomes in Conventional Severity Categories of Traumatic Brain Injury: Capturing the Continuous Spectrum of Injury
dc.typeJournal Article
pubs.elements-id567820
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