Research of the relationship between R time in thrombelastography and prognosis of traumatic brain injury

Abstract

Objective To explore the relationship between R time in thrombelastography (TEG) and prognosis of traumatic brain injury (TBI). Methods The data of TBI patients were collected in Fourth Peoples Hospital in Shaanxi Province from January 2015 to June 2016. The patients were divided into two groups according to the prolongation of R time at admission, and the basic data and the outcomes were analyzed. Results In basic data, Glasgow coma scale (GCS) [(9.7±4.4) scores vs (12.1±2.2) scores]was lower, and injury severity score (ISS) [(32.4±8.9) scores vs (21.7±10.4) scores], head abbreviated injury scale (AIS) [(5.0±0.0) scores vs (4.1±1.5) scores], hemorrhage volume [(6.2±5.5) ml vs (1.1±1.8) ml] and mean arterial pressure[(127.2±28.1) mmHg vs (103.3±17.0) mmHg] were higher in the prolonged R time group. In outcomes, the in-hospital mortality (42.9% vs 17.2%) and the rate of neurosurgical intervention (71.4% vs 37.7%) were higher, and the duration of mechanically ventilated [(9.3±3.2) d vs (4.1±1.7) d], ICU stay [(10.2±4.4) d vs (5.6±2.1) d] and hospital stay [(22.4±8.1) d vs (8.3±4.7) d] were longer in prolonged R time group. The Logistic regression analysis results showed that GCS ≤8 scores, ISS>25 scores and R time >10 min were the possible risk factors of hospital mortality. Conclusion TBI patients with longer R time have worse prognosis and longer R time is the possible risk factor of hospital mortality, and the prediction efficiency of R time need to be explored and validated by more research. Key words: Thrombelastography; Craniocerebral trauma; Coagulopathy; Prognosis