Coagulopathy in Severe Traumatic Brain Injury: A Prospective Study

• DOI: 10.1097/ta.0b013e318190c3c0
• Publication Date: 2009-01-07T08:21:32Z
• Authors: Peep Talving; Rodd Benfield; Pantelis Hadjizac...; Kenji Inaba; Linda S. Chan; Demetrios Demetri...
• Keywords: Abbreviated Injury Scale

Background: The incidence and risk factors for traumatic brain injury (TBI)-associated coagulopathy after severe TBI (sTBI) the effect of this complication on outcomes have not been evaluated in any large prospective studies. Methods: Prospective study all patients admitted to surgical intensive care unit (ICU) an urban, Level I trauma center from June 2005 through May 2007 with sTBI (head Abbreviated Injury Scale score ≥3). Criteria TBI-coagulopathy included a clinical condition consistent coagulopathy, i.e. sTBI, conjunction platelet count <100,000 mm3 and/or elevated international normalized ratio activated partial thromboplastin time. following potential p < 0.2 bivariate analysis were stepwise logistic regression identify independent its association mortality: age, mechanism (blunt [B] or penetrating [P]), presence hypotension upon admission, Severity Score (ISS), Glasgow Coma (GCS), head other body area Scale, isolated injury, diffuse axonal cerebral edema, intracranial hemorrhage (intraventricular, parenchymal, subarachnoid, subdural), pneumocephalus, midline shift. Results: A total 436 (392 blunt, 44 penetrating) met criteria, whom 387 had SHI. occurred 36% (B: 33%, P: 55%; 0.0075) 34% 32%, 54%; = 0.0062). Independent found include GCS ≤8, ISS ≥16, subarachnoid hemorrhage, ICU lengths stay significantly longer SHI who developed (12.7 vs. 8.8 days; 0.006). development was associated increased mortality, adjusted odds (95% confidence interval): 9.61 (4.06–25.0); 0.0001. Conclusion: is high, especially injuries. injuries length almost 10-fold death.