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Peer-reviewedCC BYScientific Reports

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

  • Hanna Yoon1
  • Young Sun Ro2
  • Joo Jeong3
  • Eujene Jung4
  • Gwan Jin Park5
  • Yong-Gyun Jung6
  • Byung-Mo Oh7
  • Sang Hoon Song8
  • Sang Do Shin2
8 affiliations
  1. 1Department of Emergency Medicine, Yonsei University College of Medicine
  2. 2Department of Emergency Medicine, Seoul National University Hospital
  3. 3Department of Emergency Medicine, Seoul National University College of Medicine
  4. 4Department of Emergency Medicine, Chonnam National University Hospital
  5. 5Department of Emergency Medicine, Chungbuk National University Hospital
  6. 6R&D Center, EzDiatech Inc.
  7. 7Department of Rehabilitation Medicine, Seoul National University Hospital and College of Medicine
  8. 8Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine
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Abstract

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 < 0.001). The combined biomarker assay demonstrated high sensitivity (0.910; 95% CI, 0.870–0.950) and negative predictive value (0.878; 95% CI, 0.825–0.931) for detecting CT-confirmed intracranial injuries. For long-term outcomes, the combined assay was significantly associated with reduced 6-month survival (AOR: 0.09; 95% CI, 0.01–0.84). Elevated UCH-L1 alone was significantly associated with decreased odds of favorable neurological recovery (AOR: 0.17; 95% CI, 0.05–0.62). Rapid bedside measurement of GFAP and UCH-L1 enables early detection of intracranial injury and is associated with long-term outcomes following TBI. The combined assay provides complementary diagnostic and prognostic information, supporting its potential role in acute TBI evaluation and risk stratification.

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Cite

BibTeXRIS
BibTeX
@article{yoon2026diagnostic,
  title = {{Diagnostic and prognostic utility of rapid point-of-care GFAP and UCH-L1 testing in traumatic brain injury}},
  author = {Hanna Yoon and Young Sun Ro and Joo Jeong and Eujene Jung and Gwan Jin Park and Yong-Gyun Jung and Byung-Mo Oh and Sang Hoon Song and Sang Do Shin},
  journal = {Scientific Reports},
  year = {2026},
  month = sep,
  doi = {10.1038/s41598-026-69036-x},
  url = {https://doi.org/10.1038/s41598-026-69036-x},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Diagnostic and prognostic utility of rapid point-of-care GFAP and UCH-L1 testing in traumatic brain injury
AU  - Hanna Yoon
AU  - Young Sun Ro
AU  - Joo Jeong
AU  - Eujene Jung
AU  - Gwan Jin Park
AU  - Yong-Gyun Jung
AU  - Byung-Mo Oh
AU  - Sang Hoon Song
AU  - Sang Do Shin
PY  - 2026
DA  - 2026/09/01
JO  - Scientific Reports
DO  - 10.1038/s41598-026-69036-x
UR  - https://doi.org/10.1038/s41598-026-69036-x
AB  - 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 < 0.001). The combined biomarker assay demonstrated high sensitivity (0.910; 95% CI, 0.870–0.950) and negative predictive value (0.878; 95% CI, 0.825–0.931) for detecting CT-confirmed intracranial injuries. For long-term outcomes, the combined assay was significantly associated with reduced 6-month survival (AOR: 0.09; 95% CI, 0.01–0.84). Elevated UCH-L1 alone was significantly associated with decreased odds of favorable neurological recovery (AOR: 0.17; 95% CI, 0.05–0.62). Rapid bedside measurement of GFAP and UCH-L1 enables early detection of intracranial injury and is associated with long-term outcomes following TBI. The combined assay provides complementary diagnostic and prognostic information, supporting its potential role in acute TBI evaluation and risk stratification.
SN  - 2045-2322
ER  -