The Role of Biomarkers in Predicting Clinical Outcomes in Traumatic Brain Injury Patients: A Systematic Review

Abstract

Purpose: The purpose of this study was to evaluate the use of biomarkers for the assessment of patient outcomes and prognosis in comparison to the conventional methods of using GCS and radiological studies. Methods: Embase, Cochrane, and PubMed were the databases used for the search strategy. One study per biomarker was selected for each of the 5 biomarkers: S-100B, GFAP, UCH-L1, NSE and NfL. All the studies selected were published after January 2004, and a systematic review was then carried out. Results: The search process yielded 5 studies (1 for each biomarker) and 1 comparative study. The findings revealed that the levels of all the included biomarkers were elevated in the case of TBI. Furthermore, these levels are also correlated with the mode and severity of injury, the CT scan findings, the need for neurosurgical intervention and the eventual 6-month outcome in the patients. A comparison between GFAP, S-100B and NSE revealed NSE to have the highest predictive power. Conclusions: Neurological biomarkers are highly sensitive to brain injury and, thus, can be utilised for the assessment of a patient’s outcome as well as for the prediction of any future complications.