Highlights
- •Most TBI events are mild and brain damage may not be seen with standard CT imaging.
- •Serum IL-10 measurement can be used as a predictive marker of CT positivity.
- •Performance was highest in patients sampled within 90 min of trauma.
- •Maximum performance was found for patients between 36 and 66 years-old.
- •Point-of-care testing of IL-10 may help in triage of mild TBI for optimum outcomes.
Abstract
Blood-based biomarkers were recently proposed as predictors of traumatic brain injury
(TBI) outcomes. This would be a critical step forward since the majority of TBI events
are mild and structural brain damage in this group may be missed by current brain
imaging methods. We sought to determine the performance of early measurement of interleukin-10
(IL-10) to distinguish computed tomography (CT)-positive from negative patients with
mild TBI. We designed a single-center prospective observational study, which enrolled
consecutive patients classed with mild TBI according to Glasgow Coma Scale [GCS] scores
and appearance of at least one clinical symptom. Serum IL-10 levels were measured
<3 h post hospital admission. The performance of IL-10 levels in correctly classifying
patients was evaluated. IL-10 levels were significantly higher in the group with positive
CT scans (p < 0.001). With sensitivity set at 100%, the specificity of IL-10 was only 38.1%.
However, the specificities of IL-10 for prediction of negative and positive cases
increased to 59% and 49%, respectively, when both parameters were assessed within
90 min of admission. For mild TBI patients between 36 and 66 years, classification
performance increased significantly at the 100% sensitivity level with a specificity
of 93%. Our results suggest that IL-10 may be an easily accessible clinically useful
diagnostic biomarker that can distinguish between mild TBI patients with and without
structural brain damage with higher effectiveness when lower times of blood sampling
are employed and patients are between 36 and 66 years of age.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: January 21, 2023
Accepted:
January 19,
2023
Received in revised form:
January 10,
2023
Received:
November 8,
2022
Identification
Copyright
© 2023 Elsevier B.V. All rights reserved.
