Comparison of GFAP and UCH-L1 Measurements Using Two Automated Immunoassays (i-STAT® and Alinity®) for the Management of Patients with Mild Traumatic Brain Injury: Preliminary Results from a French Single-Center Approach

Int J Mol Sci. 2024 Apr 21;25(8):4539. doi: 10.3390/ijms25084539.

Abstract

The measurement of blood glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) may assist in the management of mild traumatic brain injury (mTBI). This study aims to compare GFAP and UCH-L1 values measured using a handheld device with those measured using a core laboratory platform. We enrolled 230 mTBI patients at intermediate risk of complications. Following French guidelines, a negative S100B value permits the patient to be discharged without a computed tomography scan. Plasma GFAP and UCH-L1 levels were retrospectively measured using i-STAT® and Alinity® i analyzers in patients managed within 12 h post-trauma. Our analysis indicates a strong correlation of biomarker measurements between the two analyzers. Cohen's kappa coefficients and Lin's concordance coefficients were both ≥0.7, while Spearman's correlation coefficient was 0.94 for GFAP and 0.90 for UCH-L1. Additionally, the diagnostic performance in identifying an intracranial lesion was not significantly different between the two analyzers, with a sensitivity of 100% and specificity of approximately 30%. GFAP and UCH-L1 levels measured using Abbott's i-STAT® and Alinity® i platform assays are highly correlated both analytically and clinically in a cohort of 230 patients managed for mTBI according to French guidelines.

Keywords: biological diagnosis; glial fibrillary acidic protein; mild traumatic brain injury; ubiquitin carboxy-terminal hydrolase L1.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Biomarkers* / blood
  • Brain Concussion / blood
  • Brain Concussion / diagnosis
  • Female
  • France
  • Glial Fibrillary Acidic Protein* / blood
  • Humans
  • Immunoassay / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Ubiquitin Thiolesterase* / blood
  • Young Adult

Substances

  • Ubiquitin Thiolesterase
  • Glial Fibrillary Acidic Protein
  • UCHL1 protein, human
  • GFAP protein, human
  • Biomarkers

Grants and funding

This research received no external funding.