The diagnosis of brain injuries is undergoing a significant transformation. A groundbreaking blood test, rather than the traditional costly CT scan, is being implemented at North Shore University Hospital in Manhasset, New York. This innovative approach promises to enhance patient care while reducing unnecessary exposure to radiation.
A New Diagnostic Tool
Every day, patients arrive at the bustling emergency department after falling and potentially injuring their heads. The standard procedure often involves a CT scan, which is time-consuming and exposes patients to radiation, even if the scan may not be necessary.
In a pivotal shift, North Shore University Hospital has recently adopted the i-STAT Alinity TBI test developed by Abbott. This test assesses blood for specific biomarkers that indicate brain injury, thereby minimizing reliance on radiological imaging.
Understanding the Biomarkers
Dr. Tylis Chang, the vice chair of pathology at Northwell Health, explains the science behind the test. The biomarkers targeted are proteins that naturally reside in the brain and should not appear in the bloodstream under normal circumstances. The presence of these proteins signifies a potential issue.
If both biomarkers are below a defined threshold, clinicians can confidently conclude that the patient likely does not have a significant traumatic brain injury, thus avoiding the need for a CT scan. Dr. Chidubem Iloabachie, associate chair of emergency medicine at North Shore, emphasizes the efficiency of this method, as results are available within 15 minutes using a handheld device.
Speeding Up Patient Care
One of the most remarkable aspects of this new testing method is its rapidity. Northwell has integrated the test into its lab, yielding results in approximately 30 minutes.
This swift turnaround can significantly impact patient flow in emergency departments. The simplicity of using whole blood—which includes red and white blood cells and platelets—enhances the feasibility of conducting these tests quickly and effectively.
A History of Development
The journey towards this blood-based test began over a decade ago, driven by funding from the U.S. Department of Defense. The military sought innovative ways to diagnose traumatic brain injuries in the field, leading to extensive research and development efforts.
The technology is not only applicable for adults but is also being tested in youth athletics, highlighting its potential for widespread use. Notably, MotoAmerica, a professional motorcycle racing organization, has already implemented the test on-site, showcasing its versatility in various settings.
Target Population and Limitations
At North Shore, a significant proportion of patients with suspected traumatic brain injuries are senior citizens who have experienced falls. Dr. Iloabachie notes that mild traumatic brain injuries are among the most common reasons for emergency department visits.
To assess a patient’s condition, clinicians utilize the Glasgow Coma Scale, which evaluates speech, eye opening, and motor responses. If a patient scores within a certain range, the blood test becomes an appropriate next step.
However, there are specific criteria for the test’s application. Patients must be assessed within the first 24 hours post-injury and must not be on blood thinners or have certain complications, such as seizures or penetrating trauma.
Reducing Unnecessary Scans
Since implementing the blood test, North Shore has conducted 135 assessments and successfully avoided CT scans for approximately one-third of these patients. The test is not intended to replace CT scans entirely; rather, it serves as a valuable tool to determine when a scan may not be necessary.
Dr. Chang emphasizes that while the test is groundbreaking, it does not eliminate the need for CT scans in all cases. It offers a more nuanced approach that can reduce the number of unnecessary procedures.
The Bigger Picture
The Department of Defense reports that over 436,000 military personnel experienced mild traumatic brain injuries from 2000 to 2025. Funding from the agency has played a crucial role in the evolution of diagnostic tests for these conditions, ultimately leading to the development of this blood test.
Originally, earlier test prototypes had a 12-hour window and required separation of plasma from whole blood. The current iteration, developed by Abbott, has streamlined the process to make it more efficient and accessible across various healthcare settings.
Conclusion
The integration of blood tests for diagnosing brain injuries is a promising advancement in medical technology. By offering rapid results while minimizing unnecessary radiation exposure, this approach has the potential to enhance patient care significantly. As more facilities adopt similar practices, the future of brain injury diagnosis looks brighter and more efficient than ever.
- Rapid Diagnosis: Blood tests provide results in 15-30 minutes.
- Reduced Radiation Exposure: Minimizes unnecessary CT scans.
- Wide Applicability: Useful in both adult and youth populations.
- Military Origins: Research funded by the Department of Defense.
- Improved Patient Care: Elevates efficiency in emergency departments.
Read more → www.newsday.com