About traumatic brain injury (TBI)

What is TBI?

Traumatic brain injury (TBI) is defined as a structural alteration of brain function caused by external causes. It constitutes a true silent epidemic, since the impact of its consequences is really unknown.

Estimated incidence in Europe:

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More information of TBI

Approximately 80% are defined as “mild TBI”, which although they require assistance in the emergency services and generally the performance of a cranial computed tomography (CT), they represent a relatively good prognosis, although it has been described that up to 20% may suffer long-term sequelae despite initially normal imaging test

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Study impact

Using biomarkers as detectors of brain damage

This would make it possible to evaluate its effectiveness in routine clinical practice

Avoid a test of high cost and not without adverse effects

Also, cranial CT is unnecessary in most cases. This is especially relevant in pediatric patients, where the adverse effects of radiation can be more serious.

Possibility of its pre-hospital use

Being able to determine marker levels using a POC device could avoid unnecessary transfers to emergency services.

Quick determination of biomarkers to rule out brain injuries in mild traumatic brain injury:

First multicenter study using a point of care instrument in trauma and pediatric emergency services.

Main problem of the project

Mild traumatic brain injury (TBI) represents approximately 80% of all TBI, and although its prognosis is relatively good, it represents a significant cost to the system due to the need to perform a cranial computed tomography (CT) scan, a test of high economic value and not without risks such as irradiation, especially important and dangerous in the pediatric age.

General purpose

Detect patients who may have brain damage on cranial CT using the candidate biomarker H-FABP, in order to save resources and avoid subjecting patients to a potentially damaging imaging test.

Methodology

This is a study that will include patients with mild TBI of less than twenty-four hours of evolution, recruited from the emergency services of the participating centers.

The study will be divided into two branches, so there will be a study dedicated to adult patients (over 18 years old) and another to pediatric patients (under 18 years old).

More about the protocol

WHY IS SO IMPORTANT?

Previous results of studies carried out by our group show that the H-FABP biomarker can, with 95% sensitivity, reduce by 30% the number of CT scans performed.

Resources would be saved and patients undergoing potentially damaging imaging would be avoided.

Which other goals aim to be reached?

To assess the feasibility of measuring quickly H-FABP using a Point of Care (POC) device in patients with mild TBI and to relate its levels to the presence of lesions on cranial CT.
To assess the utility of performing serial H-FABP determinations in patients with initially pathological CT and to relate it to the prognosis of TBI.
To assess whether the incorporation of new biomarkers improves the prediction of brain damage that can be done with H-FABP.
Develop and validate a POC device capable of measuring various markers of brain damage in minutes in emergency departments
Demonstrate that this device is also useful in the management of TBI in pediatric age.