Integrating Biomarkers for Real-time Risk Assessment and Outcome Prediction in Traumatic Brain Injury Management
Sweta Sahu1, Pranay Marlecha2, Tirath Patel3, Bharathi Gadad4, Nikhilesh Anand4
1JJM Medical College, 2Kempegowda Institute of Medical Sciences, 3Trinity Medical Sciences University School of Medicine, 4University of Texas Rio Grande Valley, Edinburg, Texas
Objective:
1. To assess the correlation between the normalization time of biomarkers (S100B and NSE) and recovery time as well as clinical outcomes in TBI patients.
2. To develop and validate a biomarker-driven real-time risk stratification system using S100B and NSE normalization times to enhance ICP management and improve clinical outcomes in TBI patients.
Background:
Traumatic brain injury (TBI) is a leading cause of death and disabilities. Intracranial pressure (ICP) monitoring and clinical scoring remain the gold standard for treating TBI. Biomarkers such as neuron-specific enolase (NSE) and S100B have shown prognostic value in TBI. However, their potential for real-time risk stratification and personalized treatment is still under research.
Design/Methods:
This study reviewed 100 TBI patients, stratified by how quickly their biomarkers normalized:
• Low-risk: within 7 days
• Moderate-risk: 7–10 days
• High-risk: more than 10 days
We evaluated clinical outcomes, including recovery time, ICU stay, and Glasgow Outcome Scale (GOS) scores.
Results:
The mean biomarker normalization time was 8.3 days (SD ± 3.2). A significant inverse correlation between normalization time and recovery duration (r = -0.65, p < 0.01) was observed. Patients normalizing within 7 days had favorable outcomes (GOS 4–5) more frequently (80% vs. 50%, p < 0.05). The AUC for predicting favorable outcomes was 0.78 (95% CI 0.68–0.87).
Low-risk patients (35%) had a 5-day ICU stay with no mortality. Moderate-risk patients (40%) required 10 days of ICU stay, with a 5% mortality rate. High-risk patients (25%) needed aggressive interventions, with an ICU stay of 15 days and a 20% mortality rate.
Conclusions:
Biomarker normalization times is a novel approach for stratifying TBI patients into real-time risk categories, allowing for more tailored treatment strategies and potentially improving clinical outcomes. Shorter normalization times are associated with better outcomes and faster recovery, supporting the utility of biomarkers in optimizing personalized treatment. The biomarker-based risk stratification model offers a novel method for improving ICP management and enhancing clinical outcomes in TBI patients.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.