Multicenter Evaluation of the Course of Coagulopathy in Patients with Isolated Traumatic Brain Injury: Relation to CT Characteristics and Outcome

• DOI: 10.1089/neu.2011.2044
• Publication Date: 2011-09-22T22:35:30Z
• Authors: Gaby Franschman; Christa Boer; Teuntje M.J.C. An...; Joukje van der Naalt; Janneke Horn; Iain Haitsma; Bram Jacobs; Pieter E. Vos
• Keywords: Male; neurotrauma; DIAGNOSIS; CLASSIFICATION; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; HYPERFIBRINOLYSIS; Humans; PREDICTORS; DCN NN - Brain networks and neuronal communication; ABNORMALITIES; Incidence; SEVERE HEAD-INJURY; Blood Coagulation Disorders; Middle Aged; CT characteristics; 3. Good health; PROGNOSTIC VALUE; COMPUTERIZED-TOMOGRAPHY; coagulation disorders; Brain Injuries; hemostatic monitoring; MODERATE; Female; ROTATION THROMBELASTOGRAPHY; Tomography, X-Ray Computed; patient outcome

This prospective multicenter study investigated the association of course coagulation abnormalities with initial computed tomography (CT) characteristics and outcome in patients isolated traumatic brain injury (TBI). Patient demographics, parameters, CT characteristics, data moderate severe TBI without major extracranial injuries were prospectively collected. Coagulopathy was defined as absent, early but temporary, delayed, or sustained. Delayed/sustained coagulopathy associated a higher incidence disturbed pupillary responses (40% versus 27%; p<0.001) Traumatic Coma Data Bank (TCDB) classification (5 (2–5) 2 (1–5); p=0.003) than early, short-lasting coagulopathy. The delayed/sustained more frequently showed intracranial hemorrhage signs raised pressure (ICP) compared to only. paralleled by in-hospital mortality rates (51% 33%; p<0.05), poorer 6-month functional relative risk for particularly related (OR 8.19; 95% CI 3.15,21.32; p<0.001), 6.70; 1.74,25.78; p=0.006), 5.25; 2.06,13.40; p=0.001). is unfavorable at 6 months after Our finding that not only mere presence also time holds predictive value patient underlines importance systematic hemostatic monitoring over TBI.