Traumatic brain injury (TBI) is a neurological injury resulting from external mechanical force and is one of the most common causes of long-term neurological disability and death. Approximately 69 million people suffer from mild, moderate, and severe TBI annually and many live with TBI-related disabilities. Notably, severe TBI (sTBI) has a mortality of 30-50%, while 30% of sTBI survivors have severe, chronic neurologic complications. Given the variability in TBI mechanisms, patterns of brain injury, and outcomes, determining prognosis in the early days following injury can be challenging. Current methods used for the prognosis of TBI, including neuroimaging and clinical assessment, have insufficient sensitivity and specificity. Therefore, more reliable and accurate methods are needed for the prognosis of outcome in the initial days following TBI. This is particularly important for sTBI, to allow informed discussions with surrogate decision-makers when a patient is comatose, and to help plan rehabilitation and support services.
Researchers at the University of Calgary have demonstrated that serum metabolite profiles are strongly associated with the prognosis of sTBI in adults using the Extended Glasgow Outcome Scale (GOS-E) at 3 months (short-term) and 12 months (long-term) post-injury. The serum metabolite profiles were also highly predictive of mortality at 3 months post-sTBI. Serum samples were collected one and four days post-injury from adult patients with sTBI, where proton nuclear magnetic resonance (1H-NMR) and direct injection tandem mass spectrometry (DI-MS/MS) were used to identify and quantify metabolites in patient serum samples. The researchers have shown that serum metabolomics holds promise for the prognosis of short- and long-term outcome and mortality in adults with sTBI.
AREAS OF APPLICATION
- sTBI Prognosis:
- Prognosis of GOS-E outcome in adults, both short-term and long-term
- Prediction of mortality in adults
- Highly accurate for predicting GOS-E outcome at 3- and 12- months post-injury and mortality at 3-months post-injury.
- Serum metabolomics holds promise to be more reliable than current methods used for the prognosis of sTBI in adults.
- Allows clinicians to have informed discussions with surrogate decision-makers when patients are comatose
- Allows early planning of rehabilitation and support services
- Potential to use only a minimal number of metabolites to develop predictive models.
STAGE OF DEVELOPMENT
- The testing panel is under clinical validation
- Provisional patent application filed in late 2021
- Researcher profile: Dr. Brent Winston