Diagnostic and prognostic utility of rapid point-of-care GFAP and UCH-L1 testing in traumatic brain injury

Timely identification of traumatic intracranial injuries and prediction of long-term outcomes remain critical challenges in traumatic brain injury (TBI) care. Glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have emerged as promising biomarkers for the diagnosis and prognosis of TBI. This study evaluated the diagnostic and prognostic utility of a novel point-of-care testing (POCT) platform in a real-world emergency setting.

We conducted a prospective, multicenter case–control study across five emergency departments. A total of 200 TBI patients with CT-identifiable intracranial injuries (CT + TBI) and 200 TBI patients without intracranial injuries (CT– TBI), all presenting within 24 h of injury, were enrolled. Serum GFAP and UCH-L1 levels were measured using a rapid multiplex POCT platform (VEUPLEX™ TBI Assay).

Diagnostic performance metrics were calculated. Associations between biomarker levels and 6-month survival and neurological outcomes were assessed using multivariable logistic regression among the CT + TBI patients. Median serum concentrations of both GFAP and UCH-L1 were significantly higher in the CT + TBI group compared to the CT– TBI group (medians [IQR] for GFAP: 129.95 [30.83–823.41] vs. 5.27 [3.48–6.14] pg/mL; UCH-L1: 262.23 [75.88–1170.04] vs. 58.49 [20.91–165.69] pg/mL; both p