scholarly journals Probability of Soluble Tissue Factor Release Lead to the Elevation of D-dimer as a Biomarker for Traumatic Brain Injury

2019 ◽  
Vol 59 (2) ◽  
pp. 63-67 ◽  
Author(s):  
Eiichi SUEHIRO ◽  
Yuichi FUJIYAMA ◽  
Miwa KIYOHIRA ◽  
Yukari MOTOKI ◽  
Junzo NOJIMA ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Tissue Factor ◽  
D Dimer ◽  
Factor Release

scholarly journals Prospective Analysis of Coagulopathy Associated with Isolated Traumatic Brain Injury and Clinical Outcome

2021 ◽  
Author(s):  
Gopal Krishna ◽  
Varun Aggarwal ◽  
Ishwar Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Clinical Outcome ◽  
Road Traffic ◽  
Statistical Significance ◽  
Platelet Counts ◽  
Coagulation Abnormalities ◽  
The Mean ◽  
D Dimer

Abstract Introduction Traumatic brain injury (TBI) affects the coagulation pathway in a distinct way than does extracranial trauma. The extent of coagulation abnormalities varies from bleeding diathesis to disseminated thrombosis. Design Prospective study. Methods The study included 50 patients of isolated TBI with cohorts of moderate (MHI) and severe head injury (SHI). Coagulopathy was graded according to the values of parameters in single laboratory. The incidence of coagulopathy according to the severity of TBI and correlation with disseminated intravascular coagulation (DIC) score, platelets, prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, and fibrinogen was observed. The comparison was also made between expired and discharged patients within each group. It also compared coagulation derailments with clinical presentation (Glasgow Coma Scale [GCS]) and outcome (Glasgow Outcome Scale [GOS]). Results Road traffic accident was the primary (72%) mode of injury. Fifty-two percent had MHI and rest had SHI. Eighty-four percent of cases were managed conservatively. The mean GCS was 12.23 and 5.75 in MHI and SHI, respectively. Sixty-two percent of MHI and 96% of the patients with SHI had coagulation abnormalities. On statistical analysis, DIC score (p < 0.001) strongly correlated with the severity of head injury and GOS. PT and APTT were also significantly associated with the severity of TBI. In patients with moderate TBI, D-dimer and platelet counts showed association with clinical outcome. Fibrinogen levels did not show any statistical significance. The mean platelet counts remained normal in both the groups of TBI. The mean GOS was 1.54 and 4.62 in SHI and MHI, respectively. Conclusion Coagulopathy is common in isolated TBI. The basic laboratory parameters are reliable predictors of coagulation abnormalities in TBI. Coagulopathy is directly associated with the severity of TBI, GCS, and poor outcome.

scholarly journals Correlation of D-Dimer level with outcome in traumatic brain injury

2016 ◽  
Vol 17 (1) ◽  
pp. 21-30
Author(s):  
Pradip Prasad Subedi ◽  
Sushil Krishna Shilpakar
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Stay ◽  
Glasgow Outcome Scale ◽  
Significant Proportion ◽  
Duration Of Hospital Stay ◽  
Icu Stay ◽  
The Mean ◽  
Hospital Stay Duration ◽  
D Dimer

Introduction: Traumatic brain injury (TBI) is a common neurosurgical emergency and a common public health problem with high mortality and long term morbidity. The cost incurred by TBI is immense. The major determinant of outcome following TBI is the severity of the primary injury. However, secondary injuries including coagulopathy are treatable prognostic factors. Many studies have revealed that coagulopathy of trauma depicted by increasing level of D-dimer is associated with poor prognosis in TBI. So, early dectection and correction of such abnormality is very important in management of TBI.Methods: This is a prospective observational study conducted at Department of Surgery TUTH (Tribhuvan University Teaching Hospital), Kathmandu,Nepal over a period of one year. One hundred and forty eight patients of TBI were included in the study. Clinical profile of the patients and D-dimer level were monitored during the hospital course. D-dimer level was correlated with outcome variables including duration of hospital stay, duration of Intensive care unit (ICU) stay and Glasgow outcome scale (GOS).Results: A total of 194 patients were admitted with the diagnosis of traumatic brain injury during the study period and out of them 148 patients were enrolled for the study. Out of 148 patients one hundred and twenty (81.1%) were males and twenty eight (18.9%) were females. The mean age was 29.71±18.07 and the age ranged from 1 to 78 years. Seventy (47.3%) patient were between 21 to 40 years of age. The mean duration of hospital stay was 9.83±13.58 days and the mean duration of ICU stay was 3.78±7.06 days. Contusion was the most common lesion in our patients. Of the patients studied 111 patients (75%)  had good recovery with GOS of 5, 9  patients (6.1%)  had GOS of 4, 6 patients (4.1%)  had GOS of 3, 1 patients (0.7%)  had GOS of 2 and 21 patients (14.1%)  had GOS of 1. Normal D-dimer was seen in 102 patients (68.9%) and elevated D-dimer in 46 patients (31.1%). Man –Whitney test shows higher D-dimer levels positively correlated with duration of hospital stay, duration of ICU stay and Glasgow Outcome Scale. Pearson chi-square test revealed higher levels of D-dimer correlated with grade of injury but not with mode of injury.Conclusion: D-dimer is elevated in significant proportion of patients with TBI and abnormal D-dimer level is associated with poor outcome in TBI.Journal of Society of Surgeons of Nepal Vol.17(1) 2014: 21-30

scholarly journals Age-Related Differences in the Time Course of Coagulation and Fibrinolytic Parameters in Patients with Traumatic Brain Injury

2020 ◽  
Vol 21 (16) ◽  
pp. 5613
Author(s):  
Ryuta Nakae ◽  
Yu Fujiki ◽  
Yasuhiro Takayama ◽  
Takahiro Kanaya ◽  
Yutaka Igarashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Propensity Score ◽  
Older Patients ◽  
Multivariate Logistic Regression Analysis ◽  
The Elderly ◽  
Elderly Group ◽  
Post Injury ◽  
D Dimer

Coagulopathy and older age are common and well-recognized risk factors for poorer outcomes in traumatic brain injury (TBI) patients; however, the relationships between coagulopathy and age remain unclear. We hypothesized that coagulation/fibrinolytic abnormalities are more pronounced in older patients and may be a factor in poorer outcomes. We retrospectively evaluated severe TBI cases in which fibrinogen and D-dimer were measured on arrival and 3–6 h after injury. Propensity score-matched analyses were performed to adjust baseline characteristics between older patients (the “elderly group,” aged ≥75 y) and younger patients (the “non-elderly group,” aged 16–74 y). A total of 1294 cases (elderly group: 395, non-elderly group: 899) were assessed, and propensity score matching created a matched cohort of 324 pairs. Fibrinogen on admission, the degree of reduction in fibrinogen between admission and 3–6 h post-injury, and D-dimer levels between admission and 3–6 h post-injury were significantly more abnormal in the elderly group than in the non-elderly group. On multivariate logistic regression analysis, independent risk factors for poor prognosis included low fibrinogen and high D-dimer levels on admission. Posttraumatic coagulation and fibrinolytic abnormalities are more severe in older patients, and fibrinogen and D-dimer abnormalities are negative predictive factors.

scholarly journals Serum D-Dimer Concentrations Are Increased after Pediatric Traumatic Brain Injury

2015 ◽  
Vol 166 (2) ◽  
pp. 383-388 ◽  
Author(s):  
Rachel P. Berger ◽  
Janet Fromkin ◽  
Pam Rubin ◽  
John Snyder ◽  
Rudolph Richichi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Pediatric Traumatic Brain Injury ◽  
D Dimer

Screening for venous thromboembolism in traumatic brain injury: Limitations of D-dimer assay

2003 ◽  
Vol 84 (2) ◽  
pp. 285-290 ◽  
Author(s):  
Jay M. Meythaler ◽  
Winfield S. Fisher ◽  
Loring W. Rue ◽  
Alice Johnson ◽  
Linda Davis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Venous Thromboembolism ◽  
Brain Injury ◽  
D Dimer

D-dimer as a predictor of progressive hemorrhagic injury in patients with traumatic brain injury: analysis of 194 cases

2010 ◽  
Vol 33 (3) ◽  
pp. 359-366 ◽  
Author(s):  
Heng-Li Tian ◽  
Hao Chen ◽  
Bing-Shan Wu ◽  
He-Li Cao ◽  
Tao Xu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Progressive Hemorrhagic Injury ◽  
D Dimer ◽  
Injury Analysis

scholarly journals Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Haitao Jiang ◽  
Guangshan Hao ◽  
Rui Zhang ◽  
Qi Pang
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Binary Logistic Regression ◽  
Binary Logistic Regression Analysis ◽  
Mortality And Morbidity ◽  
Creative Commons ◽  
Therapy Strategy ◽  
And Control ◽  
D Dimer

Objective: This research was designed to investigate the prognostic determinants of patients with traumatic brain injury (TBI) undergoing decompressive craniectomy (DC). Methods: The present study was a retrospective single center research including a total of 112 patients undergoing DC for TBI in Liaocheng People’s Hospital between January 2017 and December 2018. The results were measured by Extended Glasgow Outcome Sale (GOSE). The prognostic determinants were identified by univariate and binary logistic regression analysis between the deaths and survivors or favorable and unfavorable outcomes. Results: At the six-month follow-up, the mortality was 45.5% including 37 (33.0%) patients died within 30 days. The independent prognostic factors of 30-day mortality were age (p=0.033), D-dimer level at admission (p=0.032) and postoperative hypernatremia (p=0.014). Seventy five patients survived more than 30 days after DC, among which 27 (36.0%) patients had unfavorable prognosis (GOSE 1-4) and 48 (64.0%) patients presented favorable prognosis (GOSE 5-8). After 30 days from DC, the occurrence of post-traumatic hydrocephalus(PTH) (p= 0.008) was associated with unfavorable prognosis. Conclusions: Although DC is an effective treatment for TBI patients, the mortality and morbidity risk remain high. A combination of age, D-dimer level at admission and postoperative hypernatremia may be a good prognostic factor for 30-day mortality. Developing an accurate therapy strategy to prevent and control PTH may be beneficial to the 6-month prognosis for TBI patients undergoing DC. doi: https://doi.org/10.12669/pjms.36.4.2045 How to cite this:Jiang H, Hao G, Zhang R, Pang Q. Determinants affecting the prognosis of decompressive craniectomy for traumatic brain injury. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.2045 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Sign in / Sign up

Export Citation Format

Share Document