The Relationship Between Blood Levels of Ubiquitin Carboxyterminal Hydrolase L1 (UCH-L1) Protein and the Severity of Traumatic Brain Injury Based on the Glasgow Coma Scale and Rotterdam CT Score

Abstract

Objective: Traumatic brain injury (TBI) is a leading cause of disability and death worldwide, with an estimated 64-74 million cases annually. The current gold standard for diagnosis is a computed tomography (CT) scan, which has limitations such as access, cost, and radiation risk. Therefore, a simple, accessible, and safe diagnostic modality is needed, one of which is biomarker examination. This study aims to establish the relationship between blood levels of the biomarker ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) and the severity of TBI based on the Glasgow Coma Scale (GCS) and Rotterdam CT score. Material and Methods: This observational analytic study with a cross-sectional design involved 41 samples aged 18-50 years who presented to the Emergency Department of Dr. Soetomo General Hospital, Surabaya, within 3-24 hours of the incident. UCH-L1 levels were measured from blood samples using the ELISA method, and the data on UCH-L1, GCS, and Rotterdam CT scores were analyzed with SPSS 29. Results: The mean UCH-L1 level was 0.522 ± 0.592, with a cutoff value of > 0.2057, indicating moderate to severe TBI if UCH-L1 levels exceeded 0.2057. Spearman's test and correlation coefficient analysis showed a strong relationship between UCH-L1 levels and Rotterdam CT score (p < 0.05), as well as between UCH-L1 levels and TBI severity based on GCS (p < 0.05). The cutoff value for Rotterdam CT score was > 2, indicating moderate to severe TBI if the score exceeded 2. Conclusion: Serum UCH-L1 levels are significantly associated with the severity of TBI based on GCS and Rotterdam CT score. Keywords: Traumatic brain injury, UCH-L1, Rotterdam CT score, Glasgow Coma Scale