ROLE OF INFLAMMATORY AND NEURONAL CSF BIOMARKERS IN PREDICTING THE ONSET OF INTRACRANIAL HYPERTENSION AFTER TRAUMATIC BRAIN INJURY juliopaza98@gmail.com

PW05-01

ROLE OF INFLAMMATORY AND NEURONAL CSF BIOMARKERS IN PREDICTING THE ONSET OF INTRACRANIAL HYPERTENSION AFTER TRAUMATIC BRAIN INJURY

4

Mexico

Oral or Poster

Intracranial hypertension (ICH) is a major determinant of poor outcomes in moderate to severe traumatic brain injury (TBI). Cerebrospinal fluid (CSF) biomarkers reflecting neuroinflammation and neuronal damage may offer predictive value for early ICH detection.This study aimed to assess whether cerebrospinal fluid levels of GFAP, S100B, IL-6, and NSE can serve as predictors for the onset of intracranial hypertension following TBI.

We retrospectively analyzed 60 adult TBI patients (GCS 4–12) admitted to a neurosurgical ICU from 2019 to 2023. All received external ventricular drains within 6 hours of injury, and CSF samples were tested using ELISA. ICH was defined as sustained ICP ≥22 mmHg. We examined how biomarker predictive value for ICH amd 30-day mortality and ICU length of stay. Statistical analyses included ROC curves, Youden’s Index, and correlation tests (p < 0.05).

Among 60 patients ICH occurred in 53.3% of patients. GFAP was the most accurate predictor (AUC = 0.89),with >8.1 ng/mL yielding 90% sensitivity and 86% specificity. S100B, IL-6, and NSE followed with AUCs of 0.84, 0.80, and 0.72.Combining GFAP and S100B improved accuracy (AUC = 0.92). Elevated biomarker levels significantly correlated with longer ICU stay (r = 0.64, p = 0.002) and higher 30-day mortality (OR = 3.7, 95% CI: 1.4–9.6, p = 0.01).No significant associations were found with age,sex,or mechanism of injury.

CSF biomarkers of neuroinflammation and neuronal injury, particularly GFAP and S100B,effectively predict the onset of ICH in TBI.Their integration into clinical protocols could minimize dependence on invasive ICP monitoring and enable timely therapeutic decisions.