title: Fibrinolytic markers and neurologic outcome in traumatic brain injury.
abstract: OBJECTIVE
  To determine the usefulness of fibrinolytic markers as early prognostic indicators in patients with isolated head trauma.
  
  
  METHODS
  Sixty-two consecutive patients (26 women and 36 men; mean age 61 years, range 2-76 years) with isolated head trauma seen within the first three hours of the trauma were included in the study. The Glasgow Coma score (GCS), platelet counts (Plt), prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, fibrin degradation products (FDP) and D-dimer levels were measured. Head computerized tomography (CT) findings were categorized as brain edema, linear fracture, depressed fracture, contusion and bleeding. Plt counts, PT, PTT, fibrinogen, FDP, D-dimer levels and CT findings were compared with both GCS and mortality in the first week. Statistical significance was accepted at P <or=0.05.
  
  
  RESULTS
  A marked negative relationship was found between GCS and PT, PTT, FDP and D-dimer levels (P < 0.001). Plt levels did not correlate with GCS. Mortality was most strongly related to GCS, PT, FDP and D-dimer levels (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). We found no relationship between mortality and CT findings, nor was there any significant relationship between Plt, PTT and fibrinogen levels.
  
  
  CONCLUSIONS
  GCS and fibrinolytic markers measured within the first three hours were useful in determining the prognosis of patients with isolated head trauma.
authors.affiliation: Department of Emergency Medicine, Selcuk University, Meram Faculty of Medicine, Konya, Turkey. a_bayir@hotmail.com.
authors.forename: Aysegül
authors.initials: A
authors.lastname: Bayir
authors.forename: Erdal
authors.initials: E
authors.lastname: Kalkan
authors.forename: Sedat
authors.initials: S
authors.lastname: Koçak
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ak
authors.forename: Basar
authors.initials: B
authors.lastname: Cander
authors.forename: Said
authors.initials: S
authors.lastname: Bodur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers; D001780:Blood Coagulation Tests; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000097:blood; D005260:Female; D005342:Fibrinolysis / Q000502:physiology*; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers