TY  - JOUR
PY  - 2015//
TI  - Acute traumatic coagulopathy accompanying isolated traumatic brain injury is associated with worse long-term functional and cognitive outcomes
JO  - Neurocritical care
A1  - Abdelmalik, Peter A.
A1  - Boorman, David W.
A1  - Tracy, Joseph
A1  - Jallo, Jack
A1  - Rincon, Fred
SP  - 361
EP  - 370
VL  - 24
IS  - 3
N2  - BACKGROUND: Approximately one-third of patients with isolated traumatic brain injury (iTBI) present with acute traumatic coagulopathy (ATC). ATC is associated with increased morbidity and mortality. Its effects on long-term functional and cognitive outcomes are not as well characterized. <br><br>METHODS: Data from the Citicoline Brain Injury Treatment Trial (COBRIT) were analyzed retrospectively. Exclusion criteria were renal failure or malignancy, and any extracranial injury severity score >3. ATC was defined as INR > 1.3, PTT > 38 s, or platelets < 100 K, determined at baseline, and during the first 7 days of hospitalization. <br><br>RESULTS: Six hundred forty-seven patients were included; 21 % were found to have ATC. Highest incidence occurred at baseline, and Day Two. Forty-two percent of ATC patients had a GCS < 8, compared with 11.3 % of non-ATC patients (p < 0.001). A significantly higher proportion of ATC patients was transfused blood products, required greater than 4L of fluids, demonstrated hyperthermia and hypothermia, were hypotensive and demonstrated elevated lactate when compared to non-ATC patients. In-hospital mortality, mean hospital length of stay, incidence of DVT and seizures were also significantly higher in ATC patients. A significantly lower portion of ATC patients had good outcomes on the GOS-E (i.e., score > 6), and the DRS (i.e., score < 2) at 180 days, for which ATC was found to be an independent predictor with binary logistic regression. ATC patients also performed significantly worse on several components of the CVLT-II at 180 days. <br><br>CONCLUSIONS: ATC accompanying iTBI is associated with worse functional and cognitive outcomes at 180 days.<p />  <p>Language: en</p>
LA  - en
SN  - 1541-6933
UR  - http://dx.doi.org/10.1007/s12028-015-0191-0
ID  - ref1
ER  -