Journal article
Acquired coagulopathy of traumatic brain injury defined by routine laboratory tests: Which laboratory values matter?
The journal of trauma and acute care surgery, Vol.76(1), pp.121-125
01/01/2014
DOI: 10.1097/TA.0b013e3182a9cc95
PMID: 24368366
Abstract
BACKGROUND: Coagulopathy is a major determinant of disability and death in patients with traumatic intracranial hemorrhage. However, the correlation between coagulopathy defined by routine coagulation tests and clinical outcomes in traumatic brain injury (TBI) is not well defined. The aim of our study was to determine the effect of coagulopathy diagnosed by routine laboratory tests on outcomes in TBI patients.
METHODS: We performed a retrospective cohort analysis of all isolated TBI patients exclusive of prehospital antiplatelet and anticoagulants with coagulation tests, namely, international normalized ratio (INR), platelet count, and partial thromboplastin time at admission. We defined coagulopathy by an INR of 1.5 or greater, partial thromboplastin time of 35 or greater, or platelet count of 100 x 10(3)/mu L or less. Outcome measures were progression on repeat head computed tomography (RHCT), need for neurosurgical intervention, and mortality.
RESULTS: A total of 591 patients were enrolled, with a mean (SD) age of 47.4 (26.5) years and 67% being male. Of the patients, 13.3% were coagulopathic at admission. Platelet count of 100 x 10(3)/mu L or less was an independent predictor of progression on RHCT (odd ratio [OR], 4; 95% confidence interval [CI], 1.7-10), need for neurosurgical intervention (OR, 3.6; 95% CI, 1.2-6.1), and mortality (OR, 2.6; 95% CI, 1.1-4.8). INR was an independent predictor of progression on RHCT (OR, 2; 95% CI, 1.1-4.3).
CONCLUSION: Routine bedside coagulation parameters at admission play an important role in predicting outcomes in blunt TBI. Platelet count is the strongest predictor for progression of initial insult on RHCT, need for neurosurgical intervention, and mortality. (Copyright (C) 2014 by Lippincott Williams & Wilkins)
Details
- Title: Subtitle
- Acquired coagulopathy of traumatic brain injury defined by routine laboratory tests: Which laboratory values matter?
- Creators
- Bellal Joseph - University of ArizonaHassan Aziz - University of ArizonaBardiya Zangbar - University of ArizonaNarong Kulvatunyou - University of ArizonaViraj Pandit - University of ArizonaTerence O'Keeffe - University of ArizonaAndrew Tang - University of ArizonaJulie Wynne - University of ArizonaRandall S. Friese - University of ArizonaPeter Rhee - University of Arizona
- Resource Type
- Journal article
- Publication Details
- The journal of trauma and acute care surgery, Vol.76(1), pp.121-125
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TA.0b013e3182a9cc95
- PMID
- 24368366
- ISSN
- 2163-0755
- eISSN
- 2163-0763
- Number of pages
- 5
- Language
- English
- Date published
- 01/01/2014
- Academic Unit
- Surgery
- Record Identifier
- 9984701640902771
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