Coagulation abnormalities, such as disseminated intravascular coagulation (DIC), are associated with progressive hemcrrhagic injury (PHI) following head trauma. However, the exact relationship between coagulopathy...Coagulation abnormalities, such as disseminated intravascular coagulation (DIC), are associated with progressive hemcrrhagic injury (PHI) following head trauma. However, the exact relationship between coagulopathy and PHI remains unclear. The present study utilized a scoring system defined by the International Society of Thrombosis and Haemostasis to investigate whether a high DIC score is predictive for PHI. This study was a multicenter prospective design involving four hospitals, a 6-month observation, and follow-up. Of 352 traumatic brain injury (TBI) patients, serial CT scan indicated approximately one third of patients developed progressive hemorrhage, which was most frequently observed in the frontal, temporal, and orbitofrontal lobes of patients with brain contusion. PHI-positive patients exhibited poor prognosis, as indicated by prolonged length of hospital/intensive care unit stay and high mortality. More importantly, a DIC score after TBI, as well as patient age and sex, could serve as predictors for PHI. In addition, DIC scores were closely associated with injury severity. Therefore, the DIC scoring system facilitated early PHI diagnosis in TBI patients, and DIC scores might serve as a valuable predictor for TBI patients with PHI.展开更多
基金the National Natural Science Foundation of China,No. 81000518 and 30770824China Postdoc-toral Science Foundation,No. 201003237+2 种基金the Scien-tific Research Foundation for the Returned Overseas Chinese Scholars,Ministry of Education of ChinaShang-hai Pujiang Program,No. 09PJ1408300the Science and Technology Commission of Shanghai Municipality Project,No. 10JC1402300.
文摘Coagulation abnormalities, such as disseminated intravascular coagulation (DIC), are associated with progressive hemcrrhagic injury (PHI) following head trauma. However, the exact relationship between coagulopathy and PHI remains unclear. The present study utilized a scoring system defined by the International Society of Thrombosis and Haemostasis to investigate whether a high DIC score is predictive for PHI. This study was a multicenter prospective design involving four hospitals, a 6-month observation, and follow-up. Of 352 traumatic brain injury (TBI) patients, serial CT scan indicated approximately one third of patients developed progressive hemorrhage, which was most frequently observed in the frontal, temporal, and orbitofrontal lobes of patients with brain contusion. PHI-positive patients exhibited poor prognosis, as indicated by prolonged length of hospital/intensive care unit stay and high mortality. More importantly, a DIC score after TBI, as well as patient age and sex, could serve as predictors for PHI. In addition, DIC scores were closely associated with injury severity. Therefore, the DIC scoring system facilitated early PHI diagnosis in TBI patients, and DIC scores might serve as a valuable predictor for TBI patients with PHI.