CC BY-NC-ND 4.0 · Asian J Neurosurg 2017; 12(04): 648-652
DOI: 10.4103/ajns.AJNS_192_14
Original Article

Contributing factors for coagulopathy in traumatic brain injury

Ajit Shrestha
Department of Surgery, Neurosurgery Unit, Chitwan Medical College, Bharatpur
,
Ramesh Joshi
1   Department of Neurological Surgery, National Institute of Neurological and Allied Sciences, Kathmandu
,
Upendra Devkota
1   Department of Neurological Surgery, National Institute of Neurological and Allied Sciences, Kathmandu
› Author Affiliations

Context: In traumatic brain injury patients, coagulation disorder causes secondary brain injury, thereby increasing mortality and morbidity. Aims: The aim of this study is to identify the factors responsible for coagulopathy in traumatic brain injury. Settings and Design: This prospective longitudinal study from June 2012 included 100 patients with moderate and severe head injury presenting to National Institute of Neurological and Allied Sciences, Kathmandu, over 1-year period. Subjects and Methods: Patients were evaluated for the development of coagulopathy, defined as collectively three abnormal hemostatic parameters, and associated risk factors for coagulopathy. They were then analyzed for correlation with coagulopathy. Statistical Analysis Used: SPSS version 16 was used for the analysis of data. For identification of contributing factors, a stepwise logistic regression analysis was performed, including the factors with P < 0.05 from the analysis. Results: Among the 100 patients, coagulopathy was present in 63% of cohort. Forty-three patients had severe head injury, and 76.7% (n = 33) of them had coagulopathy compared to 52.7% (n = 30) in 57 patients with moderate head injury (P = 0.013). Statistically significant correlation with coagulopathy was present with polytrauma, severity of head injury, blood transfusion, surgical intervention, and Marshall's classification of CT of the head; however, stepwise logistic regression analysis showed that blood transfusion, surgical intervention, polytrauma, and severity of head injury were significant independent variables responsible for the development of coagulopathy. Conclusions: Traumatic brain injury is complicated with coagulopathy in up to 63% of patients. Blood transfusion, surgical intervention, polytrauma, and severity of head injury are significant independent variables responsible for coagulopathy.



Publication History

Article published online:
20 September 2022

© 2017. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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