title: Platelet dysfunction is an early marker for traumatic brain injury-induced coagulopathy.
abstract: BACKGROUND
  The goal of this study is to determine the presence of platelet dysfunction in patients with traumatic brain injury (TBI). The mechanisms underlying the coagulopathy associated with TBI remain elusive. The question of platelet dysfunction in TBI is unclear.
  
  
  METHODS
  This was a prospective observational study conducted at Memorial Hospital of South Bend, IN, and Denver Health Medical Center, CO. A total of 50 patients sustaining TBI, and not under treatment with anticoagulants or platelet inhibitors, were analyzed utilizing modified thromboelastography (TEG) with platelet mapping (TEG/PM), along with standard coagulation tests.
  
  
  RESULTS
  Compared to normal controls, patients with severe TBI had a significantly increased percentage of platelet ADP and arachidonic acid (AA) receptor inhibition. Furthermore, the percentage of ADP inhibition distinguished between survivors and non-survivors in patients with TBI (Mann-Whitney test, P = 0.035). ADP inhibition correlates strongly with severity of TBI (Mann-Whitney test, P = 0.014), while AA inhibition did not.
  
  
  CONCLUSIONS
  These data indicate that early platelet dysfunction is prevalent after severe TBI, can be measured in a point-of-care setting using TEG/PM, and correlates with mortality. The mechanism responsible for this platelet dysfunction and associated implications for TBI management remains to be defined.
authors: W. M. Keck Center for Transgene Research, University of Notre Dame, Notre Dame, IN 46556, USA.
authors: Patrick K
authors: PK
authors: Davis
authors: Harsha
authors: H
authors: Musunuru
authors: Mark
authors: M
authors: Walsh
authors: Robert
authors: R
authors: Cassady
authors: Robert
authors: R
authors: Yount
authors: Andrew
authors: A
authors: Losiniecki
authors: Ernest E
authors: EE
authors: Moore
authors: Max V
authors: MV
authors: Wohlauer
authors: Janet
authors: J
authors: Howard
authors: Victoria A
authors: VA
authors: Ploplis
authors: Francis J
authors: FJ
authors: Castellino
authors: Scott G
authors: SG
authors: Thomas
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001778:Blood Coagulation Disorders / Q000097:blood; D001791:Blood Platelet Disorders / Q000097:blood*; D001930:Brain Injuries / Q000097:blood* / Q000175:diagnosis; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests / Q000379:methods; D011446:Prospective Studies; D018048:Receptors, Purinergic P2 / Q000378:metabolism; D013916:Thrombelastography / Q000379:methods*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D018048:Receptors, Purinergic P2