Serum cleaved tau protein and traumatic mild head injury: a preliminary study in the Thai population
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ORIGINAL ARTICLE
Serum cleaved tau protein and traumatic mild head injury: a preliminary study in the Thai population P. Wuthisuthimethawee • S. Saeheng T. Oearsakul
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Received: 13 September 2012 / Accepted: 4 February 2013 / Published online: 15 February 2013 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Purpose To determine the correlation between serum cleaved tau protein and traumatic mild head injury (MHI) (GCS 13–15). Methods A prospective observational study was conducted. Blood specimens from 12 healthy persons and 44 adult patients with traumatic MHI were collected in the emergency department to measure the cleaved tau protein level using a Human Tau phosphoSerine 396 ELISA kit. A brain computed tomography (CT) scan was done in all patients. The serum cleaved tau protein level was considered positive at a cut-off point of 0.1 pg/ml. An intracranial lesion was defined as any abnormality detected by brain CT scan. Results The mean age of the traumatic MHI patients was 34.9 ± 15.6 years (range 15–74). The median GCS was 15. The median time from injury to arrival at the emergency department was 30 min. There were 11 intracranial lesions detected by brain CT scan (25.0 %). Serum cleaved tau protein was not detected in either healthy or traumatic MHI patients. Conclusion As it was uncorrelated with traumatic MHI, serum cleaved tau protein proved to be an unreliable biomarker to use in the early detection of and decision-making for traumatic MHI patients at the emergency department.
P. Wuthisuthimethawee (&) Department of Emergency Medicine, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand e-mail: [email protected] S. Saeheng T. Oearsakul Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Keywords Serum cleaved tau protein Traumatic mild head injury Emergency department Biomarker
Introduction Traumatic head injury is one of most common conditions of patients who visit the emergency department, and is associated with high morbidity and mortality among all traumatic patients [1, 2]. Currently, the diagnosis of head injury is based on history, mechanism of injury, Glasgow Coma Scale (GCS) score, and brain computed tomography (CT) scan. The patients are divided into three groups based on the GCS score: mild (GCS 13–15), moderate (GCS 9–12), and severe (GCS 3–8). For moderate and severe head injury patients, the indications to perform brain CT scan are clearly identifiable due to the high rate of positive intracranial lesions and the need for surgical intervention [3]. In traumatic mild head injury patients, there are some indications that a high-sensitivity brain CT scan should be performed: headache, vomiting, age [60 years old, intoxicated, short-term memory deficit, trauma above clavicle, seizure, failure to reach GCS 15 within 2 h after injury, and evidence of a fractured skull or base of skull fracture [4–7]. However, all of these diagnostic tools
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