• Linnéa Lagerstedt, Leire Azurmendi, Olli Tenovuo, Ari J Katila, TakalaRiikka S KRSKPerioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland., Kaj Blennow, NewcombeVirginia F JVFJDivision of Anaesthesia, Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom., Henna-Riikka Maanpää, Jussi Tallus, Iftakher Hossain, Mark van Gils, David K Menon, Peter J Hutchinson, Henrik Zetterberg, Jussi P Posti, and Jean-Charles Sanchez.
• Department of Specialities of Internal Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
• Front Neurol. 2020 Jan 1; 11: 376.

AbstractBackground: Patients with traumatic brain injury (TBI) exhibit a variable and unpredictable outcome. The proteins interleukin 10 (IL-10) and heart fatty acid-binding protein (H-FABP) have shown predictive values for the presence of intracranial lesions. Aim: To evaluate the individual and combined outcome prediction ability of IL-10 and H-FABP, and to compare them to the more studied proteins S100β, glial fibrillary acidic protein (GFAP), and neurofilament light (NF-L), both with and without clinical predictors. Methods: Blood samples from patients with acute TBI (all severities) were collected <24 h post trauma. The outcome was measured >6 months post injury using the Glasgow Outcome Scale Extended (GOSE) score, dichotomizing patients into: (i) those with favorable (GOSE≥5)/unfavorable outcome (GOSE ≤ 4) and complete (GOSE = 8)/incomplete (GOSE ≤ 7) recovery, and (ii) patients with mild TBI (mTBI) and patients with TBIs of all severities. Results: When sensitivity was set at 95-100%, the proteins' individual specificities remained low. H-FABP showed the best specificity (%) and sensitivity (100%) in predicting complete recovery in patients with mTBI. IL-10 had the best specificity (50%) and sensitivity (96%) in identifying patients with favorable outcome in patients with TBIs of all severities. When individual proteins were combined with clinical parameters, a model including H-FABP, NF-L, and ISS yielded a specificity of 56% and a sensitivity of 96% in predicting complete recovery in patients with mTBI. In predicting favorable outcome, a model consisting IL-10, age, and TBI severity reached a specificity of 80% and a sensitivity of 96% in patients with TBIs of all severities. Conclusion: Combining novel TBI biomarkers H-FABP and IL-10 with GFAP, NF-L and S100β and clinical parameters improves outcome prediction models in TBI.Copyright © 2020 Lagerstedt, Azurmendi, Tenovuo, Katila, Takala, Blennow, Newcombe, Maanpää, Tallus, Hossain, Gils, Menon, Hutchinson, Zetterberg, Posti and Sanchez.

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