Medico-legal application of ubiquitin C-terminal hydrolase L1 in mild and moderate head injured patients

Abstract

Abstract: Introduction: Head trauma is considered a frequent cause of death and disability in Egypt and worldwide. Evaluation of head injured patient is required in different forensic settings. Recently, biomarkers have been introduced to predict outcomes of traumatic head injury. Ubiquitin C-terminal hydrolase-L1 (UCH-L1) is one of the novel biomarkers with neuronal specific components. Thus, the current study aimed to evaluate the medico-legal application of UCH-L1 as a prognostic marker in mild and moderate head injured patients. The current study was conducted on forty-five adult subjects during the period from June 2018 to December 2018. They were divided into: 15 mild head injured patients (group I), 15 moderate head injured patients (group II) and 15 healthy subjects served as controls (group III). All participants were subjected to history taking, clinical examination, head computed tomography scan, and estimation of UCH-L1 concentration. Results: UCH-L1 concentration was significantly higher in group I and II compared to group III, moreover it was significantly higher in group II compared to group I. Significant positive correlations were observed between UCH-L1 concentration and each of hospitalization period and duration of post-traumatic amnesia in all head injured patients. The median concentration of UCH-L1 in patients who developed complications (11.90 ng/ml) was significantly higher than in patients who didn’t have complications (0.04 ng/ml). UCH-L1 could predict complications at cut off value > 0.2 ng/ml. Conclusions: Serum UCH-L1 could be useful for forensic experts to establish cause-effect relationship between poor outcome and trauma in head injured patients.