Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury
Patients with severe traumatic brain injury (STBI) often experience an abnormal hemostasis that contributes to mortality and unfavorable neurological outcomes. Objectives: We aimed to analyze epidemiologic, clinical, and laboratory factors associated with mortality in patients with STBI during the f...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-11-01
|
| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/12/12/2702 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846105679306162176 |
|---|---|
| author | Patricia Piñeiro Alberto Calvo María Dolores Pérez-Díaz Silvia Ramos Sergio García-Ramos Mercedes Power Isabel Solchaga Cristina Rey Javier Hortal Fernando Turégano Ignacio Garutti |
| author_facet | Patricia Piñeiro Alberto Calvo María Dolores Pérez-Díaz Silvia Ramos Sergio García-Ramos Mercedes Power Isabel Solchaga Cristina Rey Javier Hortal Fernando Turégano Ignacio Garutti |
| author_sort | Patricia Piñeiro |
| collection | DOAJ |
| description | Patients with severe traumatic brain injury (STBI) often experience an abnormal hemostasis that contributes to mortality and unfavorable neurological outcomes. Objectives: We aimed to analyze epidemiologic, clinical, and laboratory factors associated with mortality in patients with STBI during the first 48 h after in-hospital admission. Methods: We performed an observational retrospective study of STBI patients with associated extracranial trauma [defined as Injury Severity Score (ISS) ≥ 16 with an Abbreviated Injury Scale (AIS) head and neck ≥ 3 and Glasgow Coma Scale (GCS) ≤ 8] admitted to a Level II trauma center over seven years (2015–2021). Patients were divided into two groups: survivors and dead. We assessed differences regarding demographics, trauma severity, hemodynamics, disability, need for surgery, length of stay, transfusions, need for massive transfusion protocol, and hemostatic laboratory parameters at different time points. Results: A total of 134 STBI patients were included. Patients who died were older, mostly men, and showed higher trauma severity and disability. Hemoglobin, platelets, and clotting parameters deteriorated after admission to the emergency department (ED) with significant differences between groups within the first 24 h after admission. Platelet count < 150 × 10<sup>3</sup>/μL at ED arrival, GCS, and age were independent risk factors for mortality. Conclusions: Older age, GCS, and platelet count at ED arrival were independent risk factors for mortality in STBI patients with associated extracranial trauma. Early thrombocytopenia < 150 × 10<sup>3</sup>/μL at ED arrival may be used as a simple prognostic tool to early predict mortality between non-isolated STBI. |
| format | Article |
| id | doaj-art-043d9503f3924a5a89432f0c5179c01b |
| institution | Kabale University |
| issn | 2227-9059 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj-art-043d9503f3924a5a89432f0c5179c01b2024-12-27T14:12:34ZengMDPI AGBiomedicines2227-90592024-11-011212270210.3390/biomedicines12122702Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain InjuryPatricia Piñeiro0Alberto Calvo1María Dolores Pérez-Díaz2Silvia Ramos3Sergio García-Ramos4Mercedes Power5Isabel Solchaga6Cristina Rey7Javier Hortal8Fernando Turégano9Ignacio Garutti10Department of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of General and Digestive Surgery, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of General and Digestive Surgery, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of General and Digestive Surgery, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainDepartment of Anesthesiology and Critical Care, Gregorio Marañón Universitary General Hospital, 28007 Madrid, SpainPatients with severe traumatic brain injury (STBI) often experience an abnormal hemostasis that contributes to mortality and unfavorable neurological outcomes. Objectives: We aimed to analyze epidemiologic, clinical, and laboratory factors associated with mortality in patients with STBI during the first 48 h after in-hospital admission. Methods: We performed an observational retrospective study of STBI patients with associated extracranial trauma [defined as Injury Severity Score (ISS) ≥ 16 with an Abbreviated Injury Scale (AIS) head and neck ≥ 3 and Glasgow Coma Scale (GCS) ≤ 8] admitted to a Level II trauma center over seven years (2015–2021). Patients were divided into two groups: survivors and dead. We assessed differences regarding demographics, trauma severity, hemodynamics, disability, need for surgery, length of stay, transfusions, need for massive transfusion protocol, and hemostatic laboratory parameters at different time points. Results: A total of 134 STBI patients were included. Patients who died were older, mostly men, and showed higher trauma severity and disability. Hemoglobin, platelets, and clotting parameters deteriorated after admission to the emergency department (ED) with significant differences between groups within the first 24 h after admission. Platelet count < 150 × 10<sup>3</sup>/μL at ED arrival, GCS, and age were independent risk factors for mortality. Conclusions: Older age, GCS, and platelet count at ED arrival were independent risk factors for mortality in STBI patients with associated extracranial trauma. Early thrombocytopenia < 150 × 10<sup>3</sup>/μL at ED arrival may be used as a simple prognostic tool to early predict mortality between non-isolated STBI.https://www.mdpi.com/2227-9059/12/12/2702traumatic brain injuryintracranial hemorrhagecoagulopathythrombocytopeniamortalityemergency department |
| spellingShingle | Patricia Piñeiro Alberto Calvo María Dolores Pérez-Díaz Silvia Ramos Sergio García-Ramos Mercedes Power Isabel Solchaga Cristina Rey Javier Hortal Fernando Turégano Ignacio Garutti Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury Biomedicines traumatic brain injury intracranial hemorrhage coagulopathy thrombocytopenia mortality emergency department |
| title | Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury |
| title_full | Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury |
| title_fullStr | Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury |
| title_full_unstemmed | Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury |
| title_short | Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury |
| title_sort | early thrombocytopenia at hospital admission predicts mortality in patients with non isolated severe traumatic brain injury |
| topic | traumatic brain injury intracranial hemorrhage coagulopathy thrombocytopenia mortality emergency department |
| url | https://www.mdpi.com/2227-9059/12/12/2702 |
| work_keys_str_mv | AT patriciapineiro earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT albertocalvo earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT mariadoloresperezdiaz earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT silviaramos earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT sergiogarciaramos earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT mercedespower earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT isabelsolchaga earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT cristinarey earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT javierhortal earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT fernandoturegano earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury AT ignaciogarutti earlythrombocytopeniaathospitaladmissionpredictsmortalityinpatientswithnonisolatedseveretraumaticbraininjury |