The diagnostic values of UCH-L1 in traumatic brain injury: A meta-analysis

ABSTRACT

Traumatic brain injury (TBI) is a major health concern. The purpose of this study is to identify the diagnostic accuracy of ubiquitin C-terminal hydrolase-L1 (UCH-L1)—a protein biomarker—in comparison with CT-scan findings post-TBI. Accordingly, we conducted a systematic review of eligible studies and assessed the risk of bias according to the QUADAS-2 checklist. A total of 13 reports from 10 original studies were included. Based on our analysis, serum UCH-L1 has a high accuracy in predicting CT findings in mild to moderate TBI. Based on the QUADAS-2 checklist, this result has a high risk of bias affecting its applicability. The plasma level of UCH-L1 has moderate accuracy in predicting CT findings when assessed in all GCS levels. This result has a low risk of bias and low concerns regarding applicability. Pooled analysis suggests that the plasma/serum UCH-L1 level has high accuracy in predicting CT findings in a wide range of GCS in patients with TBI. This result has a high risk of bias and high concern about its applicability. The heterogeneity in approaching TBI biomarker interferes with drawing a definitive conclusion. Therefore, although UCH-L1 is a promising blood-based diagnostic biomarker for TBI, but due to differences in reported diagnostic accuracy, further studies are needed to recommend UCH-L1 as an alternative to CT scanning.

KEYWORDS:

• Ubiquitin C-terminal hydrolase (UCH-L1)
• traumatic brain injury (TBI)
• diagnostic test accuracy
• CT scan findings
• proteomics

Acknowledgment

KKW is stock holder of Banyan Biomarkers, Inc. We also thank Pammela Romo (University of Florida) for proof-reading this manuscript.

Funding

This work was supported by the DOD [W81XWH-14-2-0176]; NIH [1U01 NS086090-01], NIH [R21 NS085455-01].

Additional information

Funding

This work was supported by the DOD [W81XWH-14-2-0176]; NIH [1U01 NS086090-01], NIH [R21 NS085455-01].