A Study on the Predictive Value of Glial Fibrillary Acidic Protein for Prediction of Traumatic Brain Injury Severity

Background and Objectives: Head injury is an increasing consequence of different kinds of trauma. It may result in release of substances such as glial fibrillary acidic protein (GFAP) within the cerebrospinal fluid or in serum, which can be used for the measurement of severity of damage. The aim of this study was to assess the predictive value of GFAP in prediction of trauma severity in head-injured patients. Methods: In this cross-sectional study, 98 patients with head injury admitted to Shahid Beheshti Hospital of Kashan University of Medical Sciences (KAUMS) enrolled in this study during 2020-2021. The GFAP serum level, the Extended Glasgow Coma Outcome Score (EGOS), Glasgow Coma Scale (GCS), and Rotterdam computed tomography score were assessed and then analyzed by SPSS V20. Results: The mean of GCS at the time of admission and discharge and EGOS and Rotterdam scores at a 3-month follow-up all were within a mild range. In addition, on the base of EGOS, all of the patients had recovered to a good state 3 months after their injury. Statistical analysis revealed a meaningful correlation between GFAP and GCS and EGOS (P < 0.05). GFAP with sensitivity of 80.8%, specificity of 65.3%, and area under the curve of 0.804 has appropriate strength for prediction of severity of head injury. Conclusions: The sensitivity and specificity of GFAP revealed acceptable strength for prediction of severity of head injury, even when confounding factors are considered. The mean of EGOS and GCS and Rotterdam score were all within the range of mild injury. However, further detailed and multicenter studies are recommended for better clarification of the role of GFAP as a biomarker of traumatic brain injury.