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Neurocritical Care
Published in: Neurocritical Care 1/2015

01-02-2015 | Original Article

Traumatic Brain Injury Associated Coagulopathy

Authors: Airton Leonardo de Oliveira Manoel, Antonio Capone Neto, Precilla V. Veigas, Sandro Rizoli

Published in: Neurocritical Care | Issue 1/2015

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Abstract

Background

The presence of coagulopathy is common after severe trauma. The aim of this study was to identify whether isolated severe traumatic brain injury (TBI) is an independent risk factor for coagulopathy.

Methods

Prospective observational cohort of adult patients admitted to a Level I Trauma Center within 6 h of injury. Patients were categorized according to the abbreviated injury scale (AIS): Group 1-isolated severe TBI (AIS head ≥ 3 + AIS non-head < 3); Group 2-severe multisystem trauma associated with severe TBI (AIS head ≥ 3 + AIS non-head ≥ 3); Group 3-severe multisystem trauma without TBI (AIS head < 3 + AIS non-head ≥ 3). Primary outcome was the development of coagulopathy. Secondary outcome was in-hospital mortality.

Results

Three hundred and forty five patients were included (Group 1 = 48 patients, Group 2 = 137, and Group 3 = 160). Group 1 patients had the lowest incidence of coagulopathy and disseminated intravascular coagulopathy, and in general presented with better coagulation profile measured by either classic coagulation tests, thromboelastography or clotting factors. Isolated severe TBI was not an independent risk factor for the development of coagulopathy (OR 1.06; 0.35–3.22 CI, p = 0.92), however, isolated severe TBI patients who developed coagulopathy had higher mortality rates than isolated severe TBI patients without coagulopathy (66 vs. 16.6 %, p < 0.05). The presence of coagulopathy (OR 5.61; 2.65–11.86 CI, p < 0.0001) and isolated severe TBI (OR 11.51; 3.9–34.2 CI, p < 0.0001) were independent risk factors for in-hospital mortality.

Conclusion

Isolated severe TBI is not an independent risk factor for the development of coagulopathy. However, severe TBI patients who develop coagulopathy have extremely high mortality rates.
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Metadata
Title
Traumatic Brain Injury Associated Coagulopathy
Authors
Airton Leonardo de Oliveira Manoel
Antonio Capone Neto
Precilla V. Veigas
Sandro Rizoli
Publication date
01-02-2015
Publisher
Springer US
Published in
Neurocritical Care / Issue 1/2015
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-014-0026-4

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