Correlation of UCH-L1 and GFAP in predicting severity of traumatic brain injury in an Asian population

The application of biomarkers in TBI management remains underutilised with paucity of data in Asian populations. This study investigated the correlation between UCH-L1 and GFAP with TBI severity and patient outcomes in a Malaysian tertiary centre. The study was conducted at Universiti Malaya Medical Centre in Kuala Lumpur, Malaysia, from February 1, 2017, to November 30, 2019. GFAP and UCH-L1 were measured in 61 TBI cases and 19 controls. Correlations between biomarkers and TBI severity, as well as patient outcomes, were assessed using Spearman's rank correlation coefficient. GFAP/UCHL1 showed significant correlation with Marshall CT classification (r=0.437, p<0.001), Glasgow Coma Scale on arrival (r=-0.444, p<0.001), and Acute Physiology and Chronic Health Evaluation II (APACHEII) score (r=0.501, p<0.001). GFAP demonstrated fair-to-good accuracy in predicting TBI severity and outcomes. A consistent cut-off value of 0.01845 ng/mL for GFAP and 0.01960 for GFAP/UCHL1 predicted TBI severity, with high sensitivity (72.2-100%) and acceptable specificity (38.8-80.0%). GFAP and GFAP/UCHL1 showed promising utility in predicting TBI severity and patient outcomes in the Asian population. The findings underscore the potential clinical significance of biomarker assessment in TBI management, though further validation in larger cohorts is warranted.