{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:46:32Z","timestamp":1792100792521,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["U01 NS1365885"],"award-info":[{"award-number":["U01 NS1365885"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH\u201017\u2010C\u20100079"],"award-info":[{"award-number":["W81XWH\u201017\u2010C\u20100079"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute intoxication is common in patients evaluated for traumatic brain injury (TBI). However, the effect of elevated blood alcohol levels (BALs) on the diagnostic accuracy of FDA\u2010cleared biomarkers for evaluating traumatic intracranial injury on computed tomography (CT) scan, namely, glial fibrillary acidic protein (GFAP) and ubiquitin carboxy\u2010terminal hydrolase L1 (UCH\u2010L1), has not been well studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We investigated the effect of significantly elevated (&gt;300\u2009mg\/dL) and modestly elevated BAL (81\u2013300\u2009mg\/dL) at emergency department presentation on the diagnostic accuracy of GFAP and UCH\u2010L1 for predicting a positive CT in patients presenting to 18\u2009U.S. Level I trauma centers within 24\u2009h of TBI as part of the prospective, Transforming Research and Clinical Knowledge in TBI (TRACK\u2010TBI) study. Plasma GFAP and UCH\u2010L1 were measured using Abbott i\u2010STAT Alinity and ARCHITECT assays. Discrimination was evaluated using the area under the receiver operating characteristic curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2320 TRACK\u2010TBI participants studied, 54 (2.3%), 332 (14.3%), 1209 (52.1%), and 725 (31.3%) had significantly elevated BAL, modestly elevated BAL, nonelevated BAL (0\u201080\u2009mg\/dL), and no BAL available, respectively; 48.3% of the cohort had a positive brain CT. Those with significantly elevated and modestly elevated BAL were more likely to have positive CT (61.1% and 60.5% vs. 46.9% and 44.0%) and had higher plasma GFAP and UCH\u2010L1 levels than those with nonelevated BAL and no BAL available. The AUC of GFAP and UCH\u2010L1 combined for predicting CT positivity was higher in those with significantly elevated BAL (0.949) than those with modestly elevated BAL (0.858), nonelevated BAL (0.849), and no BAL available (0.883).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Modestly and significantly elevated BAL does not lower the diagnostic accuracy of GFAP and UCH\u2010L1 for predicting traumatic intracranial injury on CT. These biomarkers may be useful in decreasing avoidable brain CT imaging in persons with acute alcohol intoxication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.15109","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T01:45:36Z","timestamp":1739929536000},"page":"748-758","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Effect of blood alcohol on the diagnostic accuracy of glial fibrillary acidic protein and ubiquitin carboxy\u2010terminal hydrolase L1 for traumatic intracranial hemorrhage: A\n                    <scp>TRACK\u2010TBI<\/scp>\n                    study"],"prefix":"10.1111","volume":"32","author":[{"given":"Mark","family":"Harris","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery University of California, Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John K.","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Jain","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Public Health and Human Longevity Science University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Sun","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Public Health and Human Longevity Science University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava M.","family":"Puccio","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel C.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Sheba Medical Center Tel Hashomer  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin K. W.","family":"Wang","sequence":"additional","affiliation":[{"name":"Morehouse School of Medicine Neuroscience Institute  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O.","family":"Okonkwo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther L.","family":"Yuh","sequence":"additional","affiliation":[{"name":"Department of Radiology University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratik","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Radiology University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay D.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Medical College of Wisconsin  Milwaukee Wisconsin USA"},{"name":"Department of Neurology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina R.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Brain and Spinal Injury Center University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy J.","family":"Markowitz","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Diaz\u2010Arrastia","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Traumatic Brain Injury Clinical Research Center Penn Presbyterian Medical Center  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey T.","family":"Manley","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-8278","authenticated-orcid":false,"given":"Frederick K.","family":"Korley","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The TRACK\u2010TBI Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2022.2158228"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(95)80654-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200007133430204"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2013.08.129"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra072149"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2018.5.37293"},{"key":"e_1_2_11_8_1","volume-title":"Evaluation of Automatic Class III Designation for Banyan Brain Trauma Indicator","author":"Food and Drug Administration","year":"2018"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2217\/fnl.15.13"},{"key":"e_1_2_11_10_1","volume-title":"Abbott Receives FDA Clearance for First Commercially Available Lab\u2010based Blood Test to Help Evaluate Concussion","year":"2023"},{"key":"e_1_2_11_11_1","volume-title":"510(k) substantial equivalence determination decision summary \u2010 Abbott Alinity i System","author":"Food and Drug Administration","year":"2023"},{"key":"e_1_2_11_12_1","volume-title":"Abbott Receives FDA Clearance for Whole Blood Rapid Test to Help with Assessment of Concussion at the Patient's Bedside","author":"Abbott Laboratories","year":"2024"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14366"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30231-X"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2020.7140"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2023.01.014"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-020-01137-1"},{"key":"e_1_2_11_18_1","volume-title":"510(k) Substantial Equivalence Determination Decision Summary","author":"Food and Drug Administration","year":"2021"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1988.03410170081038"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2013.2970"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-199309000-00009"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30282-0"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-5133-4"},{"key":"e_1_2_11_24_1","volume-title":"Transforming Research and Clinical Knowledge in Traumatic Brain Injury Clinical Protocol","year":"2018"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-197911000-00004"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2010.05.018"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2017.07.022"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2010.07.238"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1089\/neur.2020.0037"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5527"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-011-0966-3"},{"key":"e_1_2_11_32_1","article-title":"Ubiquitin C\u2010terminal hydrolase\u2010L1 (UCH\u2010L1) in prediction of computed tomography findings in traumatic brain injury; a meta\u2010analysis","volume":"6","author":"Ramezani F","year":"2018","journal-title":"Emerg (Tehran)"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.0039"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/09602011.2016.1224190"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-020-01381-6"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx254"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04561-X"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2008.02944.x"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2016.4772"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.668606"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/am-pdf\/10.1111\/acem.15109","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.15109","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T09:25:45Z","timestamp":1752830745000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.15109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,18]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/acem.15109"],"URL":"https:\/\/doi.org\/10.1111\/acem.15109","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,18]]},"assertion":[{"value":"2023-11-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}