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TBI Blood Test Could Sub For CT Scan In ED

November 11, 2011
Written by: , Filed in: Diagnostic Imaging, Emergency Radiology, Neuroradiology
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A blood test could determine whether emergency patients with suspected traumatic brain injury need a CT scan—and might replace some CT scans.

So concludes a preliminary study published online Thursday in Annals of Emergency Medicine. The researchers discovered that patients with TBI had significantly higher blood levels of glial fibrillary acidic protein (GFAP) than those without.

In a statement, Linda Papa, MDCM, said:

This test has the potential for determining injury severity soon after injury, helping emergency physicians make decisions about performing CT scans, seeking neurological consultations, and transferring patients to other facilities.

Dr. Papa, of the department of emergency medicine at Orlando Regional Medical Center in Orlando, Florida, was the study’s lead author. She was quoted by HealthImaging.

The researchers obtained blood samples from 307 adult patients. Of the patients, 108 had TBI, with Glasgow Coma Scale (GCS) scores between 9 and 15, and loss of consciousness, amnesia, or disorientation. The other 199 were control subjects who were either uninjured or had injuries other than TBI. Blood samples were obtained within four hours of injury.

GFAP breakdown product (GFAP-BDP) was found in the blood of the TBI victims. According to the study’s background information, the product is released from injured glia cells.

“GFAP-BDP is detectable in serum within an hour of injury and is associated with measures of injury severity, including the GCS score, CT lesions and neurosurgical intervention,” the study concludes.

The authors said that the study is preliminary and that further research is necessary before a GFAP blood test could be recommended for clinical use. Dr. Papa said it had greater specificity than other blood tests studied for TBI. However, she said, it won’t totally replace imaging:

It is not a substitute for all CT scans, but it could possibly rule out patients who do not need them, as well as ensure that patients at risk get CT scans they need.

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