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Increased serum-GFAP in patients with severe traumatic brain injury is related to outcome

Artikel i vetenskaplig tidskrift
Författare K Nylen
Martin Öst
Ludvig Z Csajbok
Inger Nilsson
Kaj Blennow
Bengt Nellgård
Lars Rosengren
Publicerad i J Neurol Sci
Volym 240
Nummer/häfte 1-2
Sidor 85-91
ISSN 0022-510X (Print)
Publiceringsår 2006
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Institutionen för kliniska vetenskaper
Sidor 85-91
Språk en
Länkar www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adolescent, Adult, Aged, Aged, 80 and over, Brain Injuries/*blood, Child, Enzyme-Linked Immunosorbent Assay/methods, Evaluation Studies, Female, Glasgow Coma Scale, Glasgow Outcome Scale, Glial Fibrillary Acidic Protein/*blood, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Reference Values, Retrospective Studies, Sensitivity and Specificity, Time Factors
Ämneskategorier Medicin och Hälsovetenskap, Neurokirurgi

Sammanfattning

OBJECTIVES: Several studies have established the relevance of S-100 in blood as a marker of brain damage after traumatic brain injury. However, a more specific marker is required and glial fibrillary acidic protein (GFAP) is considered to be a good candidate. METHODS: In order to assess the increase of GFAP in serum (s-GFAP) after a severe traumatic brain injury (TBI) we collected daily serum samples from 59 patients with severe TBI starting on the day of the trauma. S-GFAP was measured using a sandwich ELISA. The Glasgow outcome scale (GOS) assessed outcome after 1 year. RESULTS: All but one patient had maximal s-GFAP values above the laboratory reference value (median increased 10-fold). The highest detected levels were seen during the first days after TBI and then decreased gradually. Patients with unfavourable outcome had significantly (p<0.001) higher maximal s-GFAP values in the acute phase compared with patients with favourable outcome. All patients (n=5) with s-GFAP>15.04 microg /L died (reference level<0.15 microg/L). We found no significant difference in the maximal s-GFAP levels of patients with isolated brain injury in comparison with patients with multiple traumas. CONCLUSION: Serum-GFAP is increased during the first days after a severe traumatic brain injury and related to clinical outcome.

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