Use of serum biomarkers in the diagnosis of traumatic brain injury

Objective: Traumatic brain injury (TBI) is a leading cause of death and disability in the pediatric age group. This study aimed to investigate the effectiveness of serum S100 calcium-binding protein B (S100b), ubiquitin carboxyterminal hydrolase-like1 (UCH-L1), glial fibrillary acidic protein (GFAP), and neurofilament (NF) protein levels in predicting the diagnosis and prognosis of traumatic brain injury. Methods: The research comprised head trauma patients aged 1 month to 18 years hospitalized at Mersin University Faculty of Medicine between October 2018 and November 2019. We recorded the demographic data of the patients, the type of trauma, the treatments administered in the pediatric intensive care unit (PICU), the Glasgow Coma Scale (GCS), the Pediatric Trauma Score (PTS), and the computed cerebral tomography (CT) reports. S-100b protein, UCHL-1, GFAP, and NF levels of the patients and control group were checked. The correlation between serum levels of biomarkers and GCS, CT findings, Rotterdam score, and Glasgow Outcome Scale-Extended (GOS-E) score of the patients was analyzed statistically. Results: The study included 73 patients, 49 males and 24 females. Comparing the groups revealed no statistically significant correlation between GFAP and TBI (p>0.05). However, the correlation between S-100b, UCHL-1, and NF and patient groups was statistically significant (p<0.05). The NF level was statistically higher in the PICU 24-hour group than in the control and pediatric emergency groups but statistically lower compared to the PICU 48-hour group (p<0.05). UCHL-1 levels in the PICU 24-hour group were statistically higher than those in the control group (p<0.05). The inverse correlation between GOS-E and UCHL-1 in the PICU 24-hour group was statistically significant (p<0.05). Patients with CT findings had a higher UCHL-1 level than those without(p<0.05). Conclusion: S-100b, UCHL-1, and NF may be used for the diagnosis of TBI and evaluation of its severity. Furthermore, UCHL-1 has the potential to be useful in forecasting patients' prognoses.