Advances in Biomarker Sciences and Technology (Jan 2023)
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
- Kevin K. Wang,
- Jennifer C. Munoz-Pareja,
- Lauren A. Lautenslager,
- J. Adrian Tyndall,
- Zhihui Yang,
- Maria R. Kerrigan,
- Ramon Diaz-Arrastia,
- Frederick K. Korley,
- David Okonkwo,
- Ava M. Puccio,
- John K. Yue,
- Sabrina R. Taylor,
- Pratik Mukherjee,
- Esther L. Yuh,
- Nancy R. Temkin,
- Claudia S. Robertson,
- Xiaoying Sun,
- Sonia Jain,
- Amy J. Markowitz,
- Geoffrey T. Manley,
- Opeolu Adeoye,
- Neeraj Badjatia,
- Kim Boase,
- Yelena Bodien,
- M. Ross Bullock,
- Randall Chesnut,
- John D. Corrigan,
- Karen Crawford,
- Sureyya Dikmen,
- Ann-Christine Duhaime,
- Richard Ellenbogen,
- V Ramana Feeser,
- Adam R. Ferguson,
- Brandon Foreman,
- Raquel Gardner,
- Etienne Gaudette,
- Joseph Giacino,
- Luis Gonzalez,
- Shankar Gopinath,
- Rao Gullapalli,
- J Claude Hemphill,
- Gillian Hotz,
- Joel Kramer,
- Natalie Kreitzer,
- Harvey Levin,
- Chris Lindsell,
- Joan Machamer,
- Christopher Madden,
- Alastair Martin,
- Thomas McAllister,
- Michael McCrea,
- Randall Merchant,
- Lindsay Nelson,
- Laura Ngwenya,
- Eva Palacios,
- Daniel Perl,
- Miri Rabinowitz,
- Jonathan Rosand,
- Angelle Sander,
- Gabriella Satris,
- David Schnyer,
- Seth Seabury,
- Arthur Toga,
- Alex Valadka,
- Mary Vassar,
- Paul Vespa,
- Ross Zafonte
Affiliations
- Kevin K. Wang
- Department of Neurobiology, Center for Neurotrauma, Multiomics & Biomarkers (CNMB), Morehouse School of Medicine Atlanta, GA, USA
- Jennifer C. Munoz-Pareja
- Department of Pediatric Critical Care, University of Miami Miller School of Medicine, Miami, FL, USA; Corresponding author.
- Lauren A. Lautenslager
- University of Florida College of Medicine, Gainesville, FL, USA
- J. Adrian Tyndall
- Department of Emergency Medicine, Morehouse School of Medicine, Atlanta, GA, USA
- Zhihui Yang
- Department of Neurobiology, Center for Neurotrauma, Multiomics & Biomarkers (CNMB), Morehouse School of Medicine Atlanta, GA, USA
- Maria R. Kerrigan
- University of Florida College of Medicine, Gainesville, FL, USA
- Ramon Diaz-Arrastia
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Frederick K. Korley
- University of Michigan, Department of Emergency Medicine, Ann Arbor, MI, USA
- David Okonkwo
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Ava M. Puccio
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- John K. Yue
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Sabrina R. Taylor
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Pratik Mukherjee
- Department of Radiology University of California San Francisco, San Francisco, CA, USA
- Esther L. Yuh
- Department of Radiology University of California San Francisco, San Francisco, CA, USA
- Nancy R. Temkin
- Department of Biostatistics and Neurological Surgery, University of Washington, Seattle, WA, USA
- Claudia S. Robertson
- The Center for Neurosurgical Intensive Care, Ben Taub General Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
- Xiaoying Sun
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
- Sonia Jain
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
- Amy J. Markowitz
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Geoffrey T. Manley
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Opeolu Adeoye
- University of Cincinnati, USA
- Neeraj Badjatia
- University of Maryland, USA
- Kim Boase
- University of Washington, USA
- Yelena Bodien
- Massachusetts General Hospital, USA
- M. Ross Bullock
- University of Miami, USA
- Randall Chesnut
- University of Washington, USA
- John D. Corrigan
- ABPP, Ohio State University, USA
- Karen Crawford
- University of Southern California, USA
- Sureyya Dikmen
- University of Washington, USA
- Ann-Christine Duhaime
- Mass General Hospital, USA
- Richard Ellenbogen
- University of Washington, USA
- V Ramana Feeser
- Virginia Commonwealth University, USA
- Adam R. Ferguson
- University of California, San Francisco, USA
- Brandon Foreman
- University of Cincinnati, USA
- Raquel Gardner
- University of California, San Francisco, USA
- Etienne Gaudette
- University of Southern California, USA
- Joseph Giacino
- Spaulding Rehabilitation Hospital, USA
- Luis Gonzalez
- TIRR Memorial Hermann, USA
- Shankar Gopinath
- Baylor College of Medicine, USA
- Rao Gullapalli
- University of Maryland, USA
- J Claude Hemphill
- University of California, San Francisco, USA
- Gillian Hotz
- University of Miami, USA
- Joel Kramer
- University of California, San Francisco, USA
- Natalie Kreitzer
- University of Cincinnati, USA
- Harvey Levin
- Baylor College of Medicine, USA
- Chris Lindsell
- Vanderbilt University, USA
- Joan Machamer
- University of Washington, USA
- Christopher Madden
- UT Southwestern, USA
- Alastair Martin
- University of California, San Francisco, USA
- Thomas McAllister
- Indiana University, USA
- Michael McCrea
- Medical College of Wisconsin, USA
- Randall Merchant
- Virginia Commonwealth University, USA
- Lindsay Nelson
- Medical College of Wisconsin, USA
- Laura Ngwenya
- University of Cincinnatti, USA
- Eva Palacios
- University of California, San Francisco, USA
- Daniel Perl
- Uniformed Services University, USA
- Miri Rabinowitz
- University of Pittsburgh, USA
- Jonathan Rosand
- Massachusetts General Hospital, USA
- Angelle Sander
- Baylor College of Medicine, USA
- Gabriella Satris
- University of California, San Francisco, USA
- David Schnyer
- UT Austin, USA
- Seth Seabury
- University of Southern California, USA
- Arthur Toga
- University of Southern California, USA
- Alex Valadka
- Virginia Commonwealth University, USA
- Mary Vassar
- University of California, San Francisco, USA
- Paul Vespa
- University of California, Los Angeles, USA
- Ross Zafonte
- Harvard Medical School, USA
- Journal volume & issue
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Vol. 5
pp. 38 – 49
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.
