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Longitudinal Course of Traumatic Brain Injury Biomarkers for the Prediction of Clinical Outcomes: A Review
- Source :
- Journal of Neurotrauma. 38:2490-2501
- Publication Year :
- 2021
- Publisher :
- Mary Ann Liebert Inc, 2021.
-
Abstract
- Protein biomarkers are often measured at hospital presentation to diagnose traumatic brain injury (TBI) and predict patient outcomes. However, a biomarker measurement at this single time point is no more accurate at predicting patient outcomes than less invasive and more cost-effective methods. Here, we review evidence that TBI biomarkers provide greater prognostic value when measured repeatedly over time, such that a trajectory of biomarker concentrations can be evaluated. PubMed, Google Scholar, and Cochrane Central Register were searched to identify studies from the last decade in which established TBI biomarkers had been measured at more than one time point following acute TBI, and which related their findings to patient outcomes. Twenty-two studies were identified, 18 of which focused on adults and 4 of which focused on children. Three general biomarker trajectories were identified: persistently high, persistently low, and reversal of decreasing concentrations. Downtrend reversal was highly specific to predicting poor patient outcomes. Four studies demonstrated that biomarker trajectories can be affected by therapeutic interventions. Additional studies demonstrated that biomarkers measured at a later time point offered superior prognostic value than a single measurement obtained at initial hospital presentation. Among other details, longitudinal biomarker trajectory assessments may identify ongoing injury and predict patient deterioration before clinical symptoms develop and thus help guide therapeutic interventions.
- Subjects :
- Adult
030506 rehabilitation
medicine.medical_specialty
Protein biomarkers
Traumatic brain injury
Psychological intervention
Longitudinal Course
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Brain Injuries, Traumatic
Animals
Humans
Medicine
Time point
Child
Intensive care medicine
business.industry
Glasgow Outcome Scale
Glasgow Coma Scale
Prognosis
medicine.disease
Treatment Outcome
Biomarker (medicine)
Neurology (clinical)
0305 other medical science
business
Biomarkers
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15579042 and 08977151
- Volume :
- 38
- Database :
- OpenAIRE
- Journal :
- Journal of Neurotrauma
- Accession number :
- edsair.doi.dedup.....a119560c9922afe32b65b3e6398ce3d9