Role of coagulopathy in patients with head trauma

Lozance, K; Dejanov, I; Mircevski, M

doi:10.1016/s0967-5868(98)90269-7

Cited by 14 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may damage microvasculature and ultimately contributes to thrombotic insults. Lozance et al reported that 17 to 76% of patients with head injury developed DIC [25], and Chiaretti et al reported that approximately 22.2% of children with severe head injury developed DIC, all of whom died and had shown severe brain edema [26]. In our study, 21.13% of the patients with moderate or severe head injury had developed DIC, and 26.79% of those with DIC developed early PTCI.…”

Section: Discussionsupporting

confidence: 54%

The Influence of Hemocoagulation Disorders on the Development of Posttraumatic Cerebral Infarction and Outcome in Patients with Moderate or Severe Head Trauma

Chen¹,

Xue²,

Guo³

et al. 2013

BioMed Research International

View full text Add to dashboard Cite

Posttraumatic cerebral infarction (PTCI) is a severe secondary insult of head injury and often leads to a poor prognosis. Hemocoagulation disorder is recognized to have important effects on hemorrhagic or ischemic damages. We sought to assess if posttraumatic hemocoagulation disorders were associated with cerebral infarction, and evaluate their influence on outcome among patients with moderate or severe head trauma. In this study, PTCI was observed in 28 (10.57%) of the 265 patients within the first week after injury. In multivariate analysis, the thrombocytopenia (odds ratio (OR) 2.210, 95% confidence interval (CI) 1.065–4.674), abnormal prothrombin time (PT) (OR 3.241, 95% CI 1.090–7.648), D-dimer (>2 mg/L) (OR 7.260, 95% CI 1.822–28.076), or disseminated intravascular coagulation (DIC) scores (≥5) (OR 4.717, 95% CI 1.778–12.517) were each independently associated with an increased risk of PTCI. Admission Glasgow Coma Scale (GCS) score, abnormal activated partial thromboplastin time (APTT) and fibrinogen, and D-dimer (>2 mg/L) and DIC scores (≥5) showed an independent predictive effect on poor outcome. In conclusion, recognition of this important treatable cause of PTCI and the associated risk factors may help identify the group at risk and tailor management of patients with TBI.

show abstract

Section: Discussionsupporting

confidence: 54%

The Influence of Hemocoagulation Disorders on the Development of Posttraumatic Cerebral Infarction and Outcome in Patients with Moderate or Severe Head Trauma

Chen¹,

Xue²,

Guo³

et al. 2013

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Skull fracture, as evidenced by radiologic and neurologic symptoms or signs, was also analyzed. Criteria for TBI-associated early coagulopathy included the presence of thrombocytopenia (PLT < 100,000/mL) and/or elevated INR > 1.2 and/or prolonged APTT > 36 seconds at admission [9, 10]. Early hypotension was defined as a systolic blood pressure (BP) lower than 90 mm Hg and/or diastolic pressure less than 40 mm Hg, documented in the prehospital setting or before the second CT scan was performed.…”

Section: Clinical Materials and Methodsmentioning

confidence: 99%

Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors

Chen

Guo

Chen

et al. 2012

Emergency Medicine International

View full text Add to dashboard Cite

Progressive epidural hematoma (PEDH) after head injury is often observed on serial computerized tomography (CT) scans. Recent advances in imaging modalities and treatment might affect its incidence and outcome. In this study, PEDH was observed in 9.2% of 412 head trauma patients in whom two CT scans were obtained within 24 hours of injury, and in a majority of cases, it developed within 3 days after injury. In multivariate logistic regression, patient gender, age, Glasgow Coma Scale (GCS) score at admission, and skull fracture were not associated with PEDH, whereas hypotension (odds ratio (OR) 0.38, 95% confidence interval (CI) 0.17–0.84), time interval of the first CT scanning (OR 0.42, 95% CI 0.19–0.83), coagulopathy (OR 0.36, 95% CI 0.15–0.85), or decompressive craniectomy (DC) (OR 0.46, 95% CI 0.21–0.97) was independently associated with an increased risk of PEDH. The 3-month postinjury outcome was similar in patients with PEDH and patients without PEDH (χ 2 = 0.07, P = 0.86). In conclusion, epidural hematoma has a greater tendency to progress early after injury, often in dramatic and rapid fashion. Recognition of this important treatable cause of secondary brain injury and the associated risk factors may help identify the group at risk and tailor management of patients with TBI.

show abstract

“…There was a striking predominance of male patients, total 84%, consistent with other studies as well. 4,9 A study by Talving P 10 including 436 patient with traumatic brain injury showed 78% males with overall mean age of 37±20 years. Affonseca 11 had 69.1% males in her study too.…”

Section: Discussionmentioning

confidence: 99%

“…Halpern 6 defi ned coagulopathy in his study as PT above normal range of 10.3-13.4 seconds. Lozance, 4 Selladurai 8 and Olson 9 defi ned coagulopathy as a DIC score below 6. Preston 15 defi ned coagulopathy as decreased platelet counts and FDP, aPTT and PT increased from normal values.…”

Section: Discussionmentioning

confidence: 99%

“…1 Many studies have suggested possible adverse effects of disseminated intravascular coagulation and other coagulopathies on outcome of the patients. [2][3][4][5][6][7] Post-traumatic coagulopathy, in particular, appears to be linked to secondary cerebral injury. 5,8 Although the extent of this process is yet to be elucidated fully, coagulation abnormalities are evident soon after trauma.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Coagulation disorder in moderate to severe traumatic brain injuries

2014

View full text Add to dashboard Cite

Background: Signifi cant proportions of patients presenting with moderate to severe traumatic brain injuries are diagnosed as having coagulation disorder and subsequent secondary brain injury. We evaluated the incidence of coagulopathy in patient with moderate to severe traumatic brain injury in this study. Methods: A prospective study of 100 patients with moderate to severe traumatic brain injury was carried out over a period of 2 years. Platelet count (PC), Bleeding time (BT), Clotting time (CT), Prothrombin time (PT), International Normalized ratio (INR), activated partial thromboplastin time (aPTT) and Fibrin degradation product (FDP) were measured at the time of admission and 12 hourly for 7 days. Daily D-dimer evaluation for DIC was performed in those who had abnormal value in any one of these parameters. Coagulopathy was classifi ed as collectively 3 abnormal parameters. Results: Among the 100 patients, 43% had severe and 57% had moderate traumatic brain injury. Coagulopathy was detected in 63% of total patients; 76.7% (33/43) among severe traumatic brain injury and 52.7% (30/57) among moderate (p 0.013). Multivariate statistical analysis showed deranged FDP as a signifi cant individual predictor of coagulopathy among others (p<0.001, Odds ratio 166.25; 95% confi dence interval 31.7±869.7). Conclusion: Coagulopathy is common in patients with moderate to severe traumatic brain injury. Evaluation of FDP can signifi cantly predict coagulopathy in traumatic brain injury patients.

show abstract

Role of coagulopathy in patients with head trauma

Cited by 14 publications

References 21 publications

The Influence of Hemocoagulation Disorders on the Development of Posttraumatic Cerebral Infarction and Outcome in Patients with Moderate or Severe Head Trauma

The Influence of Hemocoagulation Disorders on the Development of Posttraumatic Cerebral Infarction and Outcome in Patients with Moderate or Severe Head Trauma

Progressive Epidural Hematoma in Patients with Head Trauma: Incidence, Outcome, and Risk Factors

Coagulation disorder in moderate to severe traumatic brain injuries

Contact Info

Product

Resources

About