Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery

Tao Chang,1,&ast; Xigang Yan,2,&ast; Chao Zhao,3,&ast; Yufu Zhang,4 Bao Wang,4 Li Gao4 1Department of Emergency, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 2Department of Anesthesiology, The Second Affiliat...

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Autores principales:	Chang T, Yan X, Zhao C, Zhang Y, Wang B, Gao L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	traumatic brain injury postoperative coagulopathy surgery risk factor mortality Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/2f38a9da545c4ee18344b2840357020a
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spelling	oai:doaj.org-article:2f38a9da545c4ee18344b2840357020a2021-12-02T19:18:20ZRisk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery1178-2021https://doaj.org/article/2f38a9da545c4ee18344b2840357020a2021-09-01T00:00:00Zhttps://www.dovepress.com/risk-factors-and-neurologic-outcomes-in-patients-with-traumatic-brain--peer-reviewed-fulltext-article-NDThttps://doaj.org/toc/1178-2021Tao Chang,1,&ast; Xigang Yan,2,&ast; Chao Zhao,3,&ast; Yufu Zhang,4 Bao Wang,4 Li Gao4 1Department of Emergency, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 2Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 3Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 4Department of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li GaoDepartment of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, No. 1, Xinsi Road, Xi’an, 710038, Shaanxi Province, People’s Republic of ChinaTel +86 29-84777765Email gaoli553@163.comObjective: The purpose of this study was to explore the effect of coagulopathy in patients with traumatic brain injury (TBI) during the early postoperative period.Methods: The baseline characteristics, intraoperative management, and follow-up data of 462 patients with TBI between January 2015 and June 2019 were collected and retrospectively analyzed by multivariate logistic regression. Coagulopathy was defined as activated partial thromboplastin time > 40 s, international normalized ratio > 1.4, or platelet counts < 100× 109/L.Results: Multivariate logistic regression analysis revealed that the Glasgow Coma Scale (GCS) on admission, Injury Severity Score (ISS) on admission, pupil mydriasis, duration of surgery, intraoperative blood loss, and intraoperative crystalloid resuscitation were independent risk factors for patients who developed coagulopathy after surgery. There were statistical differences in mortality (p = 0.049), the Glasgow Outcome Scale-Extended (GCS-E; p = 0.024), and the modified Rankin Scale (p = 0.043) between the patients with and without coagulopathy 1 week after surgery. Coagulopathy within 72 h after surgery revealed the higher mortality at 1 week (66.7%), 3 months (71.4%), and 6 months (76.2%). Coagulopathy within 72 h after surgery in patients with a TBI predicted worse disease progression and unfavorable neurologic outcomes.Conclusion: Taking practical and reasonable measures to manage these risk factors may protect patients with TBI from postoperative coagulopathy.Keywords: traumatic brain injury, postoperative coagulopathy, surgery, risk factor, mortalityChang TYan XZhao CZhang YWang BGao LDove Medical Pressarticletraumatic brain injurypostoperative coagulopathysurgeryrisk factormortalityNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 17, Pp 2905-2913 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	traumatic brain injury postoperative coagulopathy surgery risk factor mortality Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	traumatic brain injury postoperative coagulopathy surgery risk factor mortality Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Chang T Yan X Zhao C Zhang Y Wang B Gao L Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery
description	Tao Chang,1,&ast; Xigang Yan,2,&ast; Chao Zhao,3,&ast; Yufu Zhang,4 Bao Wang,4 Li Gao4 1Department of Emergency, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 2Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 3Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China; 4Department of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, Xi’an, 710038, Shaanxi Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Li GaoDepartment of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, No. 1, Xinsi Road, Xi’an, 710038, Shaanxi Province, People’s Republic of ChinaTel +86 29-84777765Email gaoli553@163.comObjective: The purpose of this study was to explore the effect of coagulopathy in patients with traumatic brain injury (TBI) during the early postoperative period.Methods: The baseline characteristics, intraoperative management, and follow-up data of 462 patients with TBI between January 2015 and June 2019 were collected and retrospectively analyzed by multivariate logistic regression. Coagulopathy was defined as activated partial thromboplastin time > 40 s, international normalized ratio > 1.4, or platelet counts < 100× 109/L.Results: Multivariate logistic regression analysis revealed that the Glasgow Coma Scale (GCS) on admission, Injury Severity Score (ISS) on admission, pupil mydriasis, duration of surgery, intraoperative blood loss, and intraoperative crystalloid resuscitation were independent risk factors for patients who developed coagulopathy after surgery. There were statistical differences in mortality (p = 0.049), the Glasgow Outcome Scale-Extended (GCS-E; p = 0.024), and the modified Rankin Scale (p = 0.043) between the patients with and without coagulopathy 1 week after surgery. Coagulopathy within 72 h after surgery revealed the higher mortality at 1 week (66.7%), 3 months (71.4%), and 6 months (76.2%). Coagulopathy within 72 h after surgery in patients with a TBI predicted worse disease progression and unfavorable neurologic outcomes.Conclusion: Taking practical and reasonable measures to manage these risk factors may protect patients with TBI from postoperative coagulopathy.Keywords: traumatic brain injury, postoperative coagulopathy, surgery, risk factor, mortality
format	article
author	Chang T Yan X Zhao C Zhang Y Wang B Gao L
author_facet	Chang T Yan X Zhao C Zhang Y Wang B Gao L
author_sort	Chang T
title	Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery
title_short	Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery
title_full	Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery
title_fullStr	Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery
title_full_unstemmed	Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery
title_sort	risk factors and neurologic outcomes in patients with traumatic brain injury and coagulopathy within 72 h after surgery
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/2f38a9da545c4ee18344b2840357020a
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_version_	1718376844559908864

Risk Factors and Neurologic Outcomes in Patients with Traumatic Brain Injury and Coagulopathy Within 72 h After Surgery

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