Thrombelastography-identified coagulopathy is associated with increased morbidity and mortality after traumatic brain injury

Nicholas R. Kunio, Jerome A. Differding, Katherine M. Watson, Ryland S. Stucke, Martin A. Schreiber

    Research output: Contribution to journalArticle

    50 Scopus citations

    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.

    Original languageEnglish (US)
    Pages (from-to)584-588
    Number of pages5
    JournalAmerican journal of surgery
    Volume203
    Issue number5
    DOIs
    StatePublished - May 1 2012

    Keywords

    • Coagulopathy
    • Hypocoagulability
    • Thrombelastography
    • Traumatic brain injury

    ASJC Scopus subject areas

    • Surgery

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