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Biomarkers in Prehospital Prediction of Need for Neurosurgical Observation or Intervention in TBI Patients (PreTBI II)

23. april 2019 opdateret af: University of Aarhus

S100B and Glial Fibrillary Acidic Protein (GFAP) in Prehospital Prediction of Need for Neurosurgical Observation or Intervention in Patients Suffering Moderate Traumatic Brain Injury (TBI)

The PreTBI II study aims to investigate the diagnostic potential of prehospital S100B and GFAP measurements in prediction of need for neurosurgical observation and/or intervention in moderate TBI patients, to rule-in high-risk patients. Ultimately to select patients who will benefit from neuro surgical expertise in specialized departments and thereby possibly better patient outcome. Hopefully also minimize treatment delay, secure optimal resource consumption and streamline patient courses by predicting the presence of neurotrauma.

Hypotheses:

  1. A prehospital serum S100B level > 0,10 microgram/L and expectedly above a certain and currently unknown cut-off value indicates the need for neurosurgical observation and/or intervention in moderate TBI patients.
  2. A prehospital serum GFAP level above a certain and currently unknown cut-off value can significantly predict a need for urgent neurosurgical observation and/or intervention in moderate TBI patients.
  3. Biomarker dynamics between prehospital and in-hospital biomarker values of S100B and GFAP can significantly predict a need for urgent neurosurgical observation and/or intervention.
  4. Biomarker dynamics between prehospital and in-hospital biomarker values of S100B and GFAP can significantly predict hospital course and outcome of patients with moderate TBI.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

22

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Danmark
      • Aarhus N, Danmark, 8200
        • Prehospital Emergency Medical Services, Central Denmark Region

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 100 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

All adult patients (≥18 years) suffering isolated head trauma and receiving an ambulance or anaesthetist-staffed critical care team dispatched by the Prehospital Emergency Medical Services (EMS) in the Central Denmark Region.

Beskrivelse

Inclusion Criteria:

  • Patients presenting with Glasgow Coma Score (GCS) GCS 9-13 suffering relevant trauma and displaying relevant clinical indices compatible with TBI as evaluated by EMS staff. Patients are considered incompetent due to on-going alteration of mental state.

Exclusion Criteria:

  • Patients <18 years, GCS <9, >6 hours elapsed after trauma, unknown time of trauma, multi trauma, known dementia, chronic psychosis or active central nervous system (CNS) pathology.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Moderate TBI patients
GCS 9-13
Andet: Blodprøvetagning
Blodprøvetagning fra perifert venekateter, der rutinemæssigt indsættes i traumepatienter under transport

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Sensitivity of se-S100B in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma
Specificity of se-S100B in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma
Positive predictive value of se-S100B in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma
Negative predictive value of se-S100B in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma

Sekundære resultatmål

Resultatmål
Tidsramme
Sensitivity of se-GFAP in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma
Specificity of se-GFAP in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma
Positive predictive value of se-GFAP in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma
Negative predictive value of se-GFAP in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 7 days of trauma
in relation to event within 7 days of trauma

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Biomarkørdynamik mellem præhospital og hospitalsindlagt kombination af se-S100B, se-GFAP og se-NSE værdier i forhold til et binært udfald målt ved et ja/nej spørgsmål om "gunstigt neurologisk resultat" vælg gunstigt/ugunstigt
Tidsramme: i forhold til hændelse inden for 1 år efter traume
i forhold til hændelse inden for 1 år efter traume
Sensitivity of combined se-S100B and se-GFAP in relation to a binary outcome measured by by a yes/no question of "immediate treatment <24h/deferred treatment <24h" pick immediate/deferred
Tidsramme: in relation to event within 24 hours of trauma
in relation to event within 24 hours of trauma
Specificity of combined se-S100B and se-GFAP in relation to a binary outcome measured by by a yes/no question of "immediate treatment <24h/deferred treatment <24h" pick immediate/deferred
Tidsramme: in relation to event within 24 hours of trauma
in relation to event within 24 hours of trauma
Positive predictive value of combined se-S100B and se-GFAP in relation to a binary outcome measured by by a yes/no question of "immediate treatment <24h/deferred treatment <24h" pick immediate/deferred
Tidsramme: in relation to event within 24 hours of trauma
in relation to event within 24 hours of trauma
Negative predictive value of combined se-S100B and se-GFAP in relation to a binary outcome measured by by a yes/no question of "immediate treatment <24h/deferred treatment <24h" pick immediate/deferred
Tidsramme: in relation to event within 24 hours of trauma
in relation to event within 24 hours of trauma
Biomarker dynamics between prehospital and in-hospital se-S100B values in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 24 hours of trauma
in relation to event within 24 hours of trauma
Biomarker dynamics between prehospital and in-hospital se-GFAP values in relation to a binary outcome measured by a yes/no question of "need for neurosurgical observation and/or intervention" pick yes/no
Tidsramme: in relation to event within 24 hours of trauma
in relation to event within 24 hours of trauma
Biomarker dynamics between prehospital and in-hospital se-S100B values in relation to a binary outcome measured by a yes/no question of "favorable neurological outcome" pick favorable/unfavorable
Tidsramme: in relation to event within 1 year of trauma
Neurological outcome will be evaluated by a dichotomized glasgow outcome score extended (GOSE) as "Favorable (GOSE 5-8)/Unfavorable (GOSE 1-4)
in relation to event within 1 year of trauma
Biomarker dynamics between prehospital and in-hospital se-GFAP values in relation to a binary outcome measured by a yes/no question of "favorable neurological outcome" pick favorable/unfavorable
Tidsramme: in relation to event within 1 year of trauma
Neurological outcome will be evaluated by a dichotomized glasgow outcome score extended (GOSE) as "Favorable (GOSE 5-8)/Unfavorable (GOSE 1-4)
in relation to event within 1 year of trauma

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Aarhus

Samarbejdspartnere

Aarhus University Hospital
Central Denmark Region

Datoer for undersøgelser

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Studer store datoer

Studiestart (Faktiske)

15. februar 2017

Primær færdiggørelse (Faktiske)

1. februar 2019

Studieafslutning (Faktiske)

1. februar 2019

Datoer for studieregistrering

Først indsendt

21. november 2016

Først indsendt, der opfyldte QC-kriterier

19. januar 2017

Først opslået (Skøn)

23. januar 2017

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. april 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. april 2019

Sidst verificeret

1. maj 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • Protokol_v3_240816_PreTBI_II

Plan for individuelle deltagerdata (IPD)

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INGEN

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