Coagulation disorder in moderate to severe traumatic brain injuries

• Main Author: Ajit Shrestha
• Format: Article
• Language: English
• Published: Manipal College of Medical Sciences, Pokhara 2014-11-01
• Series: Asian Journal of Medical Sciences
• Subjects: raumatic brain injury; coagulopathy; fibrin degradation product; secondary brain injury
• Online Access: https://www.nepjol.info/index.php/AJMS/article/view/10730

Background: Significant 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 classified 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 significant individual predictor of coagulopathy among others (p < 0.001, Odds ratio 166.25; 95% confidence interval 31.7 + 869.7). Conclusion: Coagulopathy is common in patients with moderate to severe traumatic brain injury. Evaluation of FDP can significantly predict coagulopathy in traumatic brain injury patients.