Feasibility of Deploying a Point-of-Care TBI Biomarker Test in a Regional Level I Trauma Center

Abstract

Introduction: Head CT is routinely used to evaluate patients with head trauma, but the majority of scans are negative, leading to radiation exposure, prolonged emergency department (ED) stays, and resource strain. A new blood-based test (Abbott iSTAT TBI test) has demonstrated high sensitivity and negative predictive value for ruling out intracranial bleeding. We examined the feasibility and clinical impact of implementing this assay in a Level I trauma center ED.

Methods: We enrolled 30 adult patients presenting within 12 hours of head injury and a Glasgow Coma Scale of 13–15. Patients with penetrating injuries, moderate/severe TBI, immunocompromised status, or elevated blood alcohol (>0.2%) were excluded. Blood samples were analyzed on either plasma or whole blood cartridges. Key measures included test performance (sensitivity and negative predictive value) and time to disposition compared with CT-based pathways.

Results: Twenty-seven patients completed the study. The iSTAT TBI test demonstrated 100% sensitivity and negative predictive value for detecting intracranial injury. Use of the assay reduced time to disposition by 65% compared with CT-only pathways.

Discussion: Point-of-care deployment of the iSTAT TBI test was feasible and integrated smoothly into the routine ED workflow. Results suggest substantial potential to reduce unnecessary CT scans, shorten ED length of stay, and conserve resources while maintaining patient safety. These findings further support the study and integration of biomarker-guided pathways as a scalable approach for TBI evaluation.