Correlation Between Cerebrospinal Fluid Glial Fibrillary Acidic Protein (GFAP) Levels and the Severity of Traumatic Brain Injury Measured by Glasgow Coma Scale and Marshall Classification

Abstract

In comparison with other diseases that affect the human brain, Traumatic Brain Injury (TBI) has the highest incidence; it is a significant public health issue. In addition to being a critical factor in determining appropriate medical actions and predicting patients’ outcomes, assessing TBI severity is imperative. Numerous recent studies indicate that biofluid-based TBI biomarker tests have promising outcomes for diagnosing TBI severity and prognosis. Therefore, this study aimed at investigating how GFAP levels in cerebrospinal fluid correlate with TBI severity determined using GCS and Marshall Classification. This research utilized an analytical observational cross-sectional design involving fifteen TBIs who underwent ICP monitor installation at healthcare centres within Surabaya's Dr Soetomo General Hospital from January to March 2024. 15 subjects tested GCS based on clinical conditions at initial hospitalization, calculated Marshall Classification based on radiological examination and protein levels of GFAP on LCS when ICP Monitor was installed. Correlation test of CSF GFAP level with GCS obtained a correlation coefficient value r = 0.939, means there is a strong correlation. CSF GFAP level and Marshall Classification shows a strong correlation (r = 0.695). There is a significant correlation between the CSF GFAP with the Glasgow Coma Scale and the Marshall Classification.