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Báo cáo y học: "Acute and delayed mild coagulopathy are related to outcome in patients with isolated traumatic brain injury"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Acute and delayed mild coagulopathy are related to outcome in patients with isolated traumatic brain injury. | Greuters et al. Critical Care 2011 15 R2 http ccforum.eom content 15 1 R2 KS CRITICAL CARE RESEARCH Open Access Acute and delayed mild coagulopathy are related to outcome in patients with isolated traumatic brain injury 1 1 1 1 2 Sjoerd Greuters Annelies van den Berg Gaby Franschman Victor A Viersen Albertus Beishuizen Saskia M Peerdeman3 Christa Boer1 ALARM-BLEEDING investigators Abstract Introduction The relationship between isolated traumatic brain injury TBI associated coagulopathy and patient prognosis frequently lacks information regarding the time course of coagulation disorders throughout the post-traumatic period. This study was conducted to assess the prevalence and time course of post-traumatic coagulopathy in patients with isolated TBI and the relationship of these hemostatic disorders with outcome. Methods The local Human Subjects Committee approved the study. We retrospectively studied the medical records of computed tomography CT -confirmed isolated TBI patients with an extracranial abbreviated injury scale AIS 3 who were primarily referred to a Level 1 trauma centre in Amsterdam n 107 . Hemostatic parameters including activated partial thromboplastin time aPTT prothrombin time PT platelet count hemoglobin hematocrit glucose pH and lactate levels were recorded throughout a 72-hour period as part of a routine standardized follow-up of TBI. Coagulopathy was defined as a aPPT 40 seconds and or a PTT in International Normalized Ratio INR 1.2 and or a platelet count 120 109 l. Results Patients were mostly male aged 48 20 years with a median injury severity score of 25 range 20 to 25 . Early coagulopathy as diagnosed in the emergency department ED occurred in 24 of all patients. The occurrence of TBI-related coagulopathy increased to 54 in the first 24 hours post-trauma. In addition to an increased age and disturbed pupillary reflex both coagulopathy upon ED arrival and during the first 24 hours posttrauma provided an independent prognostic factor for .