Exploring UCH-L1 and BDNF for Precision Diagnostics and Prognostic Evaluation: A Novel Way of Severity Stratification of Traumatic Brain Injury

Traumatic brain injury remains a major global health concern, with current diagnostic tools often limited in sensitivity and prognostic accuracy. This study evaluated UCH-L1 and BDNF for their role in stratifying injury severity and predicting outcomes. A total of 310 participants were enrolled, including 250 TBI patients and 60 healthy controls. Functional outcomes were measured by the Glasgow Outcome Scale. Serum UCH-L1 and BDNF levels were quantified within 72 hours post-injury using ELISA. UCH-L1 increased progressively with injury severity, while BDNF showed an inverse trend.UCH-L1 correlated negatively with GCS (ρ = − 0.95) and GOS (ρ = − 0.59), whereas BDNF correlated positively with GCS (ρ = 0.47) and GOS (ρ = 0.46). Non-survivors had significantly higher UCH-L1 and lower BDNF compared to survivors (p < 0.001). ROC analysis showed superiority of UCH-L1 (AUC = 0.92) against GCS (AUC = 0.84) and BDNF (AUC = 0.78), while the combined model (GCS + UCH-L1 + BDNF) achieved the best predictive accuracy (AUC = 0.95). Multivariate regression identified UCH-L1 as an independent predictor of mortality (OR = 3.07, p < 0.001). These findings suggest that UCH-L1 and BDNF act as complementary biomarkers that facilitate severity stratification and prognosis prediction in traumatic brain injury.