Thrombelastography-identified coagulopathy is associated with increased morbidity and mortality after traumatic brain injury.
Am J Surg 2012;
203:584-588. [PMID:
22425448 DOI:
10.1016/j.amjsurg.2011.12.011]
[Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 12/15/2011] [Accepted: 12/15/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND
The purpose of this study was to determine the relationship between coagulopathy and outcome after traumatic brain injury.
METHODS
Patients admitted with a traumatic brain injury were enrolled prospectively and admission blood samples were obtained for kaolin-activated thrombelastogram and standard coagulation assays. Demographic and clinical data were obtained for analysis.
RESULTS
Sixty-nine patients were included in the analysis. A total of 8.7% of subjects showed hypocoagulability based on a prolonged time to clot formation (R time, > 9 min). The mortality rate was significantly higher in subjects with a prolonged R time at admission (50.0% vs 11.7%). Patients with a prolonged R time also had significantly fewer intensive care unit-free days (8 vs 27 d), hospital-free days (5 vs 24 d), and increased incidence of neurosurgical intervention (83.3% vs 34.9%).
CONCLUSIONS
Hypocoagulability as shown by thrombelastography after traumatic brain injury is associated with worse outcomes and an increased incidence of neurosurgical intervention.
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