Early coagulopathy after isolated severe traumatic brain injury: relationship with hypoperfusion challenged.

摘要: Introduction The purpose of this study was to examine the incidence tissue hypoperfusion in victims severe traumatic brain injury (sTBI) and determine associations between TBI coagulopathy. Methods This is a retrospective analysis prospectively collected cohort admitted surgical intensive care unit from June 2005 December 2007 sustaining isolated sTBI, defined as sTBI [head Abbreviated Injury Scale (AIS) ≥ 3] with chest, abdomen, extremity AIS 1.2 or prolonged activated partial thromboplastin time > 36 seconds at admission. Hypoperfusion by presence an arterial base deficit (BD) 6 mmol/L. Univariate multivariate performed identify among hypoperfusion, coagulopathy, mortality. Results A total 132 patients met criteria. TBI-associated early coagulopathy occurred 48 (36.4%). With increasing head severity, increased stepwise fashion. Mean BD values mean lactate were significantly higher compared their noncoagulopathic counterparts hospital coagulopathic presented more frequently mmol/L admission (39.6% vs. 20.2%, p = 0.016). In logistic regression analysis, 5 independently associated Coagulopathy mortality after blunt trauma, adjusted odds ratio (95% confidence interval): 3.79 (1.06-13.51); 0.04. Conclusion independent risk factor for development sTBI. Nevertheless, does not occur exclusively experiencing hypoperfusion.