Why is mTBI patient management a key concern in the ED?

69 million people suffer from a traumatic brain injury (TBI) worldwide every year.¹ Defined as an alteration of brain function caused by an external force, TBI is a major public health burden.

Moderate and severe TBI require hospitalisation typically with intensive medical care and/or surgery, while the majority of patients with mild TBI (mTBI) may be discharged after medical evaluation, except for those rare cases with intracranial complications (lesions, ICLs) requiring in-hospital observation and treatment.

70-90% of TBIs are considered mild^1,2 yet they constitute one of the most frequent reasons for Emergency Department (ED) admissions.³

Current methods to assess traumatic brain injuries can be subjective and time-consuming.⁴ Because ICL is a critical risk, Computed Tomography (CT) scans are the reference method to identify them.

However, up to 90% mTBI patients’ scans show no brain abnormalities.⁵ If you could avoid these unnecessary CT-scans, you would free up your resources, considerably reduce your mTBI patient workup time and potentially reduce the overall burden on your ED.

1 IN 10
ED PATIENTS
HAS A TRAUMATIC
BRAIN INJURY³

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How can testing biomarkers change the game?

Diagnostic labs now have the capacity to fill the gap by testing for glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1), two biomarkers released from two different cell types in the hours following a brain injury.

Testing these blood-based brain biomarkers together can safely rule out ICL, reducing the need for a head CT-scan. Although head CT-scans are currently considered the reference method, some regions are now leveraging research that supports combined testing of GFAP and UCH-L1 to review and update guidelines.

For example, in France, several key Scientific Societies* have released in 2022 a recommendation addressing the initial pre- and in-hospital management of patients with mild traumatic brain injury patients. The panel of 22 experts strongly agreed on several recommendations for mTBI patients management, including on the following (R2.2.2):

"The experts suggest to use blood-based assay combining UCH-L1 and GFAP, when they are available, during the 12 hours following mild traumatic brain injury, in patients at intermediate risk (cf.R2.1), the objective being to limit the number of brain scans”

Gil-Jardiné C, et al. Management of patients suffering from mild traumatic brain injury 2023.
Anaesth Crit Care Pain Med. 2023 Aug;42(4):101260

* Société Française de Médecine d’Urgence (SFMU); Société Française d’Anesthésie et Réanimation (SFAR); with participation of the Société Française de Biologie Clinique (SFBC), the Société Française de Radiologie (SFR), and the Société Française de Médecine Physique et Réadaptation (SOFMER).

Why is VIDAS^®TBI (GFAP, UCH-L1) the markers of choice for mTBI patient management?

VIDAS^®TBI (GFAP, UCH-L1) is designed for the VIDAS^® 3 and VIDAS^® KUBE immunoanalyzers, already used by more than 27,000 labs worldwide – chances are, your lab already owns one. The VIDAS^® range has been trusted by labs for over three decades for rapid and reliable automated immunoassay testing. VIDAS^®TBI (GFAP, UCH-L1) is a versatile and effective test for GFAP and UCH-L1 that can improve confidence and efficiency in mTBI patient management. Here are some of the advantages if you prescribe VIDAS^®TBI (GFAP, UCH-L1):

• On-demand, 24/7 testing with all-inclusive kits
• Wide population of adult patients can benefit from this test
• Large testing window of up to 12 hours after the injury.
• Safely rules out ICL (Intracranial lesions)
• Enables objective determination of the need for a head CT-scan
  • Can avoid unnecessary exposure to radiation, optimizes use of resources and can help reduce time spent in the ED
• Results in less than 40 minutes
  • May help reduce costs and ensure more ED patients can be cared for in a timelier manner