AUTHOR=Posti Jussi P. , Takala Riikka S. K. , Raj Rahul , Luoto Teemu M. , Azurmendi Leire , Lagerstedt Linnéa , Mohammadian Mehrbod , Hossain Iftakher , Gill Jessica , Frantzén Janek , van Gils Mark , Hutchinson Peter J. , Katila Ari J. , Koivikko Pia , Maanpää Henna-Riikka , Menon David K. , Newcombe Virginia F. , Tallus Jussi , Blennow Kaj , Tenovuo Olli , Zetterberg Henrik , Sanchez Jean-Charles 

TITLE=Admission Levels of Interleukin 10 and Amyloid β 1–40 Improve the Outcome Prediction Performance of the Helsinki Computed Tomography Score in Traumatic Brain Injury

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.549527

DOI=10.3389/fneur.2020.549527

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> Blood biomarkers may enhance outcome prediction performance of head computed tomography scores in traumatic brain injury (TBI).</p><p><bold>Objective:</bold> To investigate whether admission levels of eight different protein biomarkers can improve the outcome prediction performance of the Helsinki computed tomography score (HCTS) without clinical covariates in TBI.</p><p><bold>Materials and methods:</bold> Eighty-two patients with computed tomography positive TBIs were included in this study. Plasma levels of β-amyloid isoforms 1–40 (Aβ40) and 1–42 (Aβ42), glial fibrillary acidic protein, heart fatty acid-binding protein, interleukin 10 (IL-10), neurofilament light, S100 calcium-binding protein B, and total tau were measured within 24 h from admission. The patients were divided into favorable (Glasgow Outcome Scale—Extended 5–8, <italic>n</italic> = 49) and unfavorable (Glasgow Outcome Scale—Extended 1–4, <italic>n</italic> = 33) groups. The outcome was assessed 6–12 months after injury. An optimal predictive panel was investigated with the sensitivity set at 90–100%.</p><p><bold>Results:</bold> The HCTS alone yielded a sensitivity of 97.0% (95% CI: 90.9–100) and specificity of 22.4% (95% CI: 10.2–32.7) and partial area under the curve of the receiver operating characteristic of 2.5% (95% CI: 1.1–4.7), in discriminating patients with favorable and unfavorable outcomes. The threshold to detect a patient with unfavorable outcome was an HCTS &gt; 1. The three best individually performing biomarkers in outcome prediction were Aβ40, Aβ42, and neurofilament light. The optimal panel included IL-10, Aβ40, and the HCTS reaching a partial area under the curve of the receiver operating characteristic of 3.4% (95% CI: 1.7–6.2) with a sensitivity of 90.9% (95% CI: 81.8–100) and specificity of 59.2% (95% CI: 40.8–69.4).</p><p><bold>Conclusion:</bold> Admission plasma levels of IL-10 and Aβ40 significantly improve the prognostication ability of the HCTS after TBI.</p>