Which means your doctors have a lot of work to do to prevent that from happening. Unless your doctor just announces that to you and walks away, giving up. Has your stroke doctor given you ANY EXACT PATH TO 100% RECOVERY? NO? Then your doctor has given up on getting you recovered like you want to be recovered. Guidelines and crapola statements like; 'All strokes are different, all stroke recoveries are different' means your doctor knows nothing about getting you 100% recovered.
Early Blood Tests Predict Death, Severe Disability for Traumatic Brain Injury
In addition to their known diagnostic value, day-of-injury glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) plasma concentrations have good to excellent prognostic value for predicting death and unfavourable outcome following traumatic brain injury (TBI), but not for predicting incomplete recovery at 6 months, according to a study published in The Lancet Neurology.
“Early and accurate prediction of TBI outcomes will help clinicians gauge how severe a brain injury is and inform how best to counsel family members about care(So, GIVING UP!) for their loved ones with brain injury and what to expect with regards to their recovery,” said Frederick Korley, MD, University of Michigan Medical School, Ann Arbor, Michigan. “It will also help researchers more precisely target promising TBI therapeutics to the right TBI patients.”
The study included patients aged 17 years and older who were evaluated for TBI at 18 US level 1 trauma centres as part of the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, between February 26, 2015, and August 8, 2018. All patients received head CT at evaluation, had adequate visual acuity and hearing preinjury, and were fluent in either English or Spanish. The researchers analysed data from 1,696 patients who had day-of-injury plasma samples for measurement of GFAP and UCH-L1 and completed 6-month assessments for outcome due to TBI with the Glasgow Outcome Scale-Extended (GOSE-TBI).
Of the patients, 120 (7.1%) died, 235 (13.9%) had an unfavourable outcome (ie, GOSE-TBI ≤4), 1,135 (66.9%) had incomplete recovery (ie, GOSE-TBI <8), and 561 (33.1%) recovered fully (ie, GOSE-TBI = 8).
The area under the curve (AUC) of GFAP for predicting death at 6 months in all patients was 0.87 (95% confidence interval [CI], 0.83-0.91), 0.86 (95% CI, 0.83-0.89) for unfavourable outcome, and 0.62 (95% CI, 0.59-0.64) for incomplete recovery. The corresponding AUCs for UCH-L1 were 0.89 (95% CI, 0.86-0.92) for predicting death, 0.86 (0.84-0.89) for unfavourable outcome, and 0.61 (0.59-0.64) for incomplete recovery at 6 months.
AUCs were higher for participants with traumatic brain injury and a Glasgow Coma Scale (GCS) score of 3 to 12 than for those with a GCS score of 13 to 15. Among the 353 patients with a GCS score of 3 to 12, adding GFAP and UCH-L1 (alone or combined) to each of the 3 International Mission for Prognosis and Analysis of Clinical Trials in traumatic brain injury models significantly increased their AUCs for predicting death (AUC range, 0.90-0.94) and unfavourable outcome (AUC range, 0.83-0.89).
However, among the 1,297 patients with a GCS score of 13 to 15, adding GFAP and UCH-L1 to the UPFRONT study model modestly increased the AUC for predicting incomplete recovery (AUC range, 0.69-0.69; P = .025).
While the method is promising for determining poor outcomes in moderate and severe TBI, the researchers said more must be done to examine its role in mild cases.
“As a next step, the TRACK-TBI team is planning a clinical trial that will examine the efficacy of promising therapeutic agents that may help traumatic brain injury patients recover quickly,” said Dr. Korley. “As part of this clinical trial, these biomarkers will be used as an objective method for selecting the right patients to enrol in this trial. We will also use these biomarkers to monitor individual patient response to these promising therapeutics.”
Reference: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00256-3/fulltext
SOURCE: Michigan Medicine - University of Michigan
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