ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025
A head-to-head comparison of S100B and GFAP/UCH-L1 for detection of traumatic intracranial lesions in a Scandinavian trauma cohort.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Clinical Effectiveness of a Blood-Based Biomarker in Patients with Mild Traumatic Brain Injury.Asian journal of neurosurgery · 2026Article
- Impact of routine use of the GFAP and UCH-L1 TBI blood test for management of mild TBI on patient care in a European emergency department.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Development of a Novel Blood-Based Assay for Brain-Derived Tau and Its Validation in Traumatic Brain Injury.medRxiv : the preprint server for health sciences · 2026Article
- Development of a monoclonal antibody-based time-resolved fluorescence immunochromatographic assay strip for rapid and quantitative determination of S100B in serum.Analytical and bioanalytical chemistry · 2026Article
- Astroglial and Neuronal Injury Markers (GFAP, UCHL-1, NfL, Tau, S100B) as Diagnostic and Prognostic Biomarkers in PTSD and Neurological Disorders.International journal of molecular sciences · 2026Review
- Trajectories of serum HIF-1α and BNIP3 are associated with injury severity and outcomes in pediatric traumatic brain injury: a prospective cohort study.BMC pediatrics · 2026Article
- CT Brain Utilization After Low-Risk Head Injury in Adults: A Retrospective Cohort Study and Literature Review.Cureus · 2026Article
- Navigating anterior pituitary dysfunction after traumatic brain injury: mechanisms, diagnosis, and management.Acta neurologica Belgica · 2025Review
- Blood Biomarkers as Optimization Tools for Computed Tomography in Mild Traumatic Brain Injury Management in Emergency Departments: A Systematic Review.Journal of personalized medicine · 2025Review
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8 authors.
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Abstract
backgroundFew countries recommend glial fibrillary protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) as a substitute for S100 astroglial calcium-binding protein B (S100B) in early detection of traumatic intracranial lesions in mild TBI (mTBI). This study aims to evaluate the classification agreement between S100B and GFAP/UCH-L1 in a Scandinavian trauma cohort, to evaluate the performance characteristics of S100B and GFAP/UCH-L1 for detection of traumatic intracranial lesions, and lastly to evaluate the laboratory performance of the GFAP/UCH-L1 assay.
methodsProspectively collected data from an unselected cohort of 379 adult trauma patients admitted to a level I trauma center at Aarhus University Hospital, Denmark, were retrospectively analyzed. Analyses were performed in the unselected cohort, in sub-cohort 1 (n = 218) i.e. patients with any evidence of TBI in their chart as well as in sub-cohort 2 (n = 105) i.e. patients with mTBI defined as Glasgow Coma Scale score ≥ 14, an injury severity score ≤ 15, and blood sampling within 6 h or 12 h after trauma. Plasma-samples were used for GFAP/UCH-L1 measurement and serum-samples were used for S100B measurement. Data analysis involved agreement analysis using Cohens kappa and sensitivity, specificity, positive predictive value and negative predictive value for each biomarker in each of the three cohorts. Lastly, levels of GFAP/UCH-L1 measured by the Alinity-I platform and the Simoa platform were compared.
resultsClassification agreement between GFAP/UCH-L1 and S100B was high in all three cohorts, but Cohens kappa improved with increasing proximity to clinical biomarker use and reached an almost perfect identity in sub-cohort 2 (0.70, 95% CI 0.62-0.92). S100b had a sensitivity and negative predictive value of 100% in sub-cohort 2, while GFAP/UCH-L1 reached 100% across all three cohorts. The specificities for both S100B and GFAP/UCH-L1 were relatively low. Comparing GFAP/UCH-L1 levels between platforms revealed a low concordance with the Alinity-I platform measuring GFAP levels on average 65% lower and UCH-L1 levels 84% higher than the Simoa platform.
conclusionsIn this study, S100B and GFAP/UCH-L1 had an almost perfect agreement for classification of mTBI patients and comparable diagnostic performances for detecting traumatic intracranial lesions. Our results therefore support GFAP/UCH-L1 as a feasible alternative to S100B for detecting traumatic intracranial lesions in mTBI.
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