title: Validating the incidence of coagulopathy and disseminated intravascular coagulation in patients with traumatic brain injury--analysis of 242 cases.
abstract: OBJECTIVE
  To estimate the incidence of coagulopathy and disseminated intravascular coagulation (DIC) in patients with traumatic brain injury (TBI) and to investigate its relationship to patient outcome.
  
  
  METHODS
  A prospective observational study.
  
  
  RESULTS
  From January 2007 to June 2009, 242 consecutive adult patients with TBI seen in three independent hospitals were recruited. Glasgow Coma Score (GCS) on admission, platelet counts (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-DT) and DIC scores were recorded for each case on admission. Clinical outcome was measured according to the Glasgow Outcome Scale (GOS) at 3 months after injury. Statistical analysis was carried using Student's t-test, one-way analysis of variance (ANOVA), and Tudey test. Coagulation abnormalities were present in approximately 50% of patients with TBI. Prolonged PT and increased D-DT and FIB levels occurred in patients with more severe brain injury and poorer outcome, and these findings were statistically significant.
  
  
  CONCLUSIONS
  Coagulation changes, particularly the incidence of DIC, may occur within 6 h after TBI and are more pronounced in patients with severe injuries and poor outcome. PT, D-DT levels and more comprehensively a DIC scores may be useful prognostic indicators in patients with TBI.
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, PR China.
authors.forename: Yirui
authors.initials: Y
authors.lastname: Sun
authors.forename: Jianqing
authors.initials: J
authors.lastname: Wang
authors.forename: Xing
authors.initials: X
authors.lastname: Wu
authors.forename: Caihua
authors.initials: C
authors.lastname: Xi
authors.forename: Yanting
authors.initials: Y
authors.lastname: Gai
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yuan
authors.forename: Ersong
authors.initials: E
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Gao
authors.forename: Jin
authors.initials: J
authors.lastname: Hu
authors.forename: Liangfu
authors.initials: L
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001777:Blood Coagulation / Q000502:physiology; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D002681:China / Q000453:epidemiology; D004211:Disseminated Intravascular Coagulation / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome