dc.contributor.author | Böhm, JK | |
dc.contributor.author | Güting, Helge | |
dc.contributor.author | Thorn, S | |
dc.contributor.author | Schäfer, Nadine | |
dc.contributor.author | Rambach, V | |
dc.contributor.author | Schöchl, Herbert | |
dc.contributor.author | Grottke, Oliver | |
dc.contributor.author | Rossaint, Rolf | |
dc.contributor.author | Stanworth, Simon | |
dc.contributor.author | Curry, Nicola | |
dc.contributor.author | Lefering, Rolf | |
dc.contributor.author | Maegele, Marc | |
dc.contributor.author | Andelic, Nada | |
dc.contributor.author | Anke, Audny | |
dc.contributor.author | Frisvold, Shirin | |
dc.contributor.author | Helseth, Eirik | |
dc.contributor.author | Røe, Cecilie | |
dc.contributor.author | Røise, Olav | |
dc.contributor.author | Skandsen, Toril | |
dc.contributor.author | Vik, Anne | |
dc.date.accessioned | 2021-01-22T11:20:30Z | |
dc.date.available | 2021-01-22T11:20:30Z | |
dc.date.created | 2021-01-19T09:12:06Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Neurocritical Care. 2020, . | en_US |
dc.identifier.issn | 1541-6933 | |
dc.identifier.uri | https://hdl.handle.net/11250/2724253 | |
dc.description.abstract | Background
Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood.
Methods
This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI. Emphasis was placed on the acute phase following TBI, primary on subgroups of patients with abnormal coagulation profile within 4 h of admission, and the impact of pre-injury anticoagulant and/or antiplatelet therapy. In order to minimise confounding factors, patients with isolated TBI (iTBI) (n = 598) were selected for this analysis.
Results
Haemostatic disorders were observed in approximately 20% of iTBI patients. In a subgroup analysis, patients with pre-injury anticoagulant and/or antiplatelet therapy had a twice exacerbated coagulation profile as likely as those without premedication. This was in turn associated with increased rates of mortality and unfavourable outcome post-injury. A multivariate analysis of iTBI patients without pre-injury anticoagulant therapy identified several independent risk factors for coagulopathy which were present at hospital admission. Glasgow Coma Scale (GCS) less than or equal to 8, base excess (BE) less than or equal to − 6, hypothermia and hypotension increased risk significantly.
Conclusion
Consideration of these factors enables early prediction and risk stratification of acute coagulopathy after TBI, thus guiding clinical management. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Springer Nature | en_US |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.title | Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI): A CENTER-TBI Analysis | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.source.journal | Neurocritical Care | en_US |
dc.identifier.doi | 10.1007/s12028-020-01151-7 | |
dc.identifier.cristin | 1873898 | |
dc.relation.project | EU/602150 | en_US |
dc.relation.project | Norges forskningsråd: 272789 | en_US |
dc.description.localcode | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |