Coagulopathy predicts poor outcome in traumatic brain injury

Fuller, G N; Pattani, Hina; Chalmers, Alison; Sperry, D; Yeoman, P

doi:10.1186/cc6347

Cited by 2 publications

(3 citation statements)

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“…Mean INR was 1.23 and 1.29 in patients with non-high risk and patients with good outcome; 1.58 and 1.56 in patients with high risk and poor outcome group respectively. Which was comparable with study by Fuller et al 7 Mean PT was 19 sec and 20 sec in patients having high risk and patients with poor outcome. The 16 sec and 15 sec mean was observed in patients non high risk and good outcome which was comparable with Gupta et al 13 Platelet count mean was 0.84 lac in patients with high-risk category and 0.88 lac in patients with poor outcome which was comparable with study by Saggar et al 14 And mean platelet count in non-high category patient was found 1.14 lac and 1.10 lac in patients with good outcome category.…”

Section: Discussionsupporting

confidence: 91%

“…This condition has been reported significantly higher in patients with TBI despite the fact there is lesser bleeding in restricted receipt of volume of fluids in isolated TBI state. 7,8 The other proposed mechanism is explained via over-activation of protein C pathway. 9 INR is a measure of extrinsic pathway of coagulation, hence determining clotting tendency of blood.…”

Section: Introductionmentioning

confidence: 99%

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Impact of coagulopathy in geriatric traumatic brain injury

et al. 2022

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Background: Traumatic brain injury (TBI) is the leading cause of death in trauma patients in various parts of the world including India. Coagulation cascade is affected in TBI. The severity of coagulopathy correlates with degree of primary injuries thus affecting the prognosis of geriatric patients. Since the prognosis of isolated TBI can be a challenge to predict at times. AIM: we wanted to study the potential of international normalized ratio (INR) test, prothrombin test (PT), platelet count as a prognostic tool in isolated TBI. Methods: INR, PT, platelet count reflects the coagulation status. In most trauma cases, it is a routine test as well. We collected the INR, PT, platelet count value at admission of 200 isolated geriatric TBI cases over a period of three months. Then, patients were followed-up and their outcome at three months from admission is scored using Glasgow outcome scale (GOS). The relationship of INR, PT, platelet count with GOS was studied.Results: From our limited study, we found that INR of 1.52, PT 17 sec or more and platelet count less than 1.10 lac predicts poor prognosis in cases of isolated geriatric TBI.Conclusions: It is important to early diagnose and early manage the coagulation abnormalities in isolated geriatric head injury patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Impact of coagulopathy in geriatric traumatic brain injury

et al. 2022

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“…Various authors in developed countries have reported the incidence of coagulation disorders in TBI. [8][9][10][11][12][13][14][15][16][17][18][19][20][21] However, data regarding the same is lacking for most low-and middle-income countries.…”

Section: Introductionmentioning

confidence: 99%

Prospective Analysis of Coagulopathy Associated with Isolated Traumatic Brain Injury and Clinical Outcome

Krishna

Aggarwal

Singh

2021

Indian Journal of Neurosurgery

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Introduction Traumatic brain injury (TBI) affects the coagulation pathway in a distinct way than does extracranial trauma. The extent of coagulation abnormalities varies from bleeding diathesis to disseminated thrombosis. Design Prospective study. Methods The study included 50 patients of isolated TBI with cohorts of moderate (MHI) and severe head injury (SHI). Coagulopathy was graded according to the values of parameters in single laboratory. The incidence of coagulopathy according to the severity of TBI and correlation with disseminated intravascular coagulation (DIC) score, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen was observed. The comparison was also made between expired and discharged patients within each group. It also compared coagulation derailments with clinical presentation (Glasgow Coma Scale [GCS]) and outcome (Glasgow Outcome Scale [GOS]). Results Road traffic accident was the primary (72%) mode of injury. Fifty-two percent had MHI and rest had SHI. Eighty-four percent of cases were managed conservatively. The mean GCS was 12.23 and 5.75 in MHI and SHI, respectively. Sixty-two percent of MHI and 96% of the patients with SHI had coagulation abnormalities. On statistical analysis, DIC score (p < 0.001) strongly correlated with the severity of head injury and GOS. PT and APTT were also significantly associated with the severity of TBI. In patients with moderate TBI, D-dimer and platelet counts showed association with clinical outcome. Fibrinogen levels did not show any statistical significance. The mean platelet counts remained normal in both the groups of TBI. The mean GOS was 1.54 and 4.62 in SHI and MHI, respectively. Conclusion Coagulopathy is common in isolated TBI. The basic laboratory parameters are reliable predictors of coagulation abnormalities in TBI. Coagulopathy is directly associated with the severity of TBI, GCS, and poor outcome.

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Coagulopathy predicts poor outcome in traumatic brain injury

Cited by 2 publications

References 6 publications

Impact of coagulopathy in geriatric traumatic brain injury

Impact of coagulopathy in geriatric traumatic brain injury

Prospective Analysis of Coagulopathy Associated with Isolated Traumatic Brain Injury and Clinical Outcome

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