Correlation of coagulation dysfunction before craniotomy, severity and prognosis of patients with traumatic brain injury

Abstract

Objective To investigate the incidence of coagulation dysfunction before craniotomy and its correlation with the severity and prognosis of patients with traumatic brain injury. Methods Seventy patients with traumatic brain injury treated by craniotomy in Qihe People’s Hospital from March 2015 to March 2017 were selected as research objects. According to the patient’s Glasgow coma score(GCS) at admission, patients were divided into mild group, medium group and severe group to compare blood coagulation dysfunction and the coagulation indexes. The patients were divided into coagulation disorder group and non coagulation disorder group according to whether had coagulopathy or not to compare the prognosis between the two groups. According to the prognosis, patients were divided into good prognosis group and poor prognosis group to compare the incidence of coagulation dysfunction and coagulation function indexes between the two groups. Results The incidence of coagulation disorders (0.00% vs. 35.00%, 50.00%, 77.27%), prothrombin time [PT, (10.34±0.28)s vs. (12.01±0.33)s, (13.53±0.41)s, (15.22±0.50)s], activated partial thromboplastin time [APTT, (28.53±2.31)s vs. (32.63±3.20)s, (35.69±3.02)s, (39.74±4.01)s], fibrinogen [FIB, (3.12±0.45)g/L vs. (2.58±0.30)g/L, (2.21±0.32)g/L, (1.82±0.41)g/L] and international normalized ratio (INR, 0.91±0.04 vs. 1.04±0.06, 1.13±0.05, 1.23±0.06), in control group, light group, medium group and severe group of traumatic brain injury patients were significantly different (P<0.05). There were significant differences in the rate of good prognosis (55.26% vs. 84.38%) and poor prognosis (44.74% vs. 15.62%) between coagulation dysfunction group and non coagulation dysfunction group (P<0.05). The incidence of coagulation disorders (26.32% vs. 85.71%), INR (1.01±0.05 vs. 1.29±0.07), PT [(12.45±0.47)s vs. (16.35±0.61)s], APTT [(33.04±5.81)s vs. (40.03±5.24)s] and FIB [(2.40±0.51)g/L vs. (1.80±0.60)g/L] were significantly different between good prognosis group and poor prognosis group (P<0.05). Conclusions The incidence of coagulation dysfunction in patients with traumatic brain injury increases with the severity of trauma, and will seriously influence the prognosis of patients. Key words: Coagulation dysfunction; Traumatic brain injury; Prognosis