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001-es BibID:BIBFORM042451
035-os BibID:PMID:22435839
Első szerző:Czeiter Endre
Cím:Brain injury biomarkers may improve the predictive power of the IMPACT outcome calculator / Endre Czeiter, Stefania Mondello, Noemi Kovacs, Janos Sandor, Andrea Gabrielli, Kara Schmid, Frank Tortella, Kevin K. W. Wang, Ronald L. Hayes, Pal Barzo, Erzsebet Ezer, Tamas Doczi, Andras Buki
Dátum:2012
ISSN:0897-7151
Megjegyzések:Outcome prediction following severe traumatic brain injury (sTBI) is a widely investigated field of research. A major breakthrough is represented by the IMPACT prognostic calculator based on admission data of more than 8500 patients. A growing body of scientific evidence has shown that clinically meaningful biomarkers, including glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), and αII-spectrin breakdown product (SBDP145), could also contribute to outcome prediction. The present study was initiated to assess whether the addition of biomarkers to the IMPACT prognostic calculator could improve its predictive power. Forty-five sTBI patients (GCS score8) from four different sites were investigated. We utilized the core model of the IMPACT calculator (age, GCS motor score, and reaction of pupils), and measured the level of GFAP, UCH-L1, and SBDP145 in serum and cerebrospinal fluid (CSF). The forecast and actual 6-month outcomes were compared by logistic regression analysis. The results of the core model itself, as well as serum values of GFAP and CSF levels of SBDP145, showed a significant correlation with the 6-month mortality using a univariate analysis. In the core model, the Nagelkerke R(2) value was 0.214. With multivariate analysis we were able to increase this predictive power with one additional biomarker (GFAP in CSF) to R(2)=0.476, while the application of three biomarker levels (GFAP in CSF, GFAP in serum, and SBDP145 in CSF) increased the Nagelkerke R(2) to 0.700. Our preliminary results underline the importance of biomarkers in outcome prediction, and encourage further investigation to expand the predictive power of contemporary outcome calculators and prognostic models in TBI.
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
biomarkers
IMPACT calculator
outcome
prognostic models
traumatic brain injury
külföldön készült közlemény
Megjelenés:Journal of Neurotrauma. - 29 : 9 (2012), p. 1770-1778. -
További szerzők:Mondello, Stefania Kovács Noémi Sándor János (1966-) (orvos-epidemiológus) Gabrielli Andrea Schmid, Kara Tortella, Frank Wang, Kevin K. W. Hayes, Ronald L. Barzó Pál Ezer Erzsébet Dóczi Tamás Büki András (1990-) (általános orvos)
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