Correlation between coagulopathy and outcome in severe head trauma in neurointensive care and trauma units

Abnormal blood coagulation after traumatic brain injury is a common finding. Some
studies have proposed these changes as useful predictors of outcome in patients with head trauma. This
study aimed at evaluating the association of the routine tests of blood coagulation within the first hours
after severe head trauma with prognosis of patients with severe head trauma.
Materials and Methods: A total of 52 patients with severe head trauma (Glasgow Coma Scale [GCS],
≤8) were admitted at Tabriz University Hospital for 1 year. Patients with major accompanying trauma
were excluded. On admission, serum levels of hemoglobin and hematocrit as well as the platelet count,
prothrombin time (PT), partial thromboplastin time (PTT), and international normalized ratio (INR)
were documented. The relation between these parameters with final outcome and also with GCS at
admission, 24 hours, 48 hours, and 1 week after admission and discharge time and Glasgow Outcome
Scale (GOS) were studied.
Results: Thirty three patients were discharged, and 19 died. There were significant negative correlations
between PT, PTT, and INR with all GCS and GOS scores. These correlations were significant and positive
between the platelet count and all GCS and GOS scores. Median PT, PTT, and INR were significantly
higher in nonsurvivors. Median serum platelets count was significantly lower in nonsurvivors.
Conclusion: On-admission PT, PTT, INR and platelet count may be used as predictors of outcome and
prognosis of patients with severe head trauma.