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This TRACK-TBI analysis sought plasma glial fibrillary acidic protein (GFAP) and UCH-L1 thresholds with high positive predictive value (PPV) for intracranial pathology in patients evaluated at level I trauma centres with Glasgow Coma Scale scores of 13–15. Blood samples were collected within 24 hours of injury. Among 1,718 participants, 633 (37%) had acute intracranial findings on CT. In CT-negative patients, day-1 GFAP discriminated those with MRI-detected pathology from those with normal MRI better than UCH-L1 (AUC 0.76, 95% CI 0.71–0.81 vs 0.60, 95% CI 0.55–0.65). Median GFAP cutoffs of 1,382 pg/mL and 2,317 pg/mL achieved adjusted PPVs of 0.90 and 0.98, respectively, for MRI-positive findings among CT-negative patients.
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This TRACK-TBI analysis sought plasma glial fibrillary acidic protein (GFAP) and UCH-L1 thresholds with high positive predictive value (PPV) for intracranial pathology in patients evaluated at level I trauma centres with Glasgow Coma Scale scores of 13–15. Blood samples were collected within 24 hours of injury. Among 1,718 participants, 633 (37%) had acute intracranial findings on CT. In CT-negative patients, day-1 GFAP discriminated those with MRI-detected pathology from those with normal MRI better than UCH-L1 (AUC 0.76, 95% CI 0.71–0.81 vs 0.60, 95% CI 0.55–0.65). Median GFAP cutoffs of 1,382 pg/mL and 2,317 pg/mL achieved adjusted PPVs of 0.90 and 0.98, respectively, for MRI-positive findings among CT-negative patients.
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