Citation

Sugimoto K, Suehiro E, Shinoyama M, Sadahiro H, Haji K, Fujiyama Y, Kawano R, Nishioka M, Suzuki M. J. Neurotrauma 2017; 34(23): 3245-3248.

Affiliation

Yamaguchi University School of Medicine, Neurosurgery, Ube, Yamaguchi, Japan ; michi@yamaguchi-u.ac.jp.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

unavailable

PMID

28895444

Abstract

Computed tomography (CT) scans are useful in patients with traumatic brain injury (TBI), but the potential risks associated with ionizing radiation are unknown. Furthermore, CT scans are not commonly available in developing countries. In this study, coagulopathy and abnormal fibrinolysis were investigated as blood biomarkers for detection of structural disorder in mild TBI. A total of 88 patients with mild and isolated TBI (Glasgow Coma Scale (GCS) score 14-15) were admitted to Kenwakai Ootemachi Hospital between October 2014 and March 2016. After exclusion of those treated with oral antiplatelet agents and anticoagulants, 73 patients were included in this study. Patients were classified into those with [lesion (+)] and without [lesion (-)] intracranial structural disorder, based on CT scans at admission and follow-up CT or magnetic resonance imaging. Age, GCS score, and blood test findings (platelet count, international normalized ratio of prothrombin time (PT-INR), activated partial thromboplastin time (APTT), fibrinogen, fibrin/fibrinogen degradation products (FDP), and D-dimer) on admission were compared between the two groups. The lesion(+) and lesion(-) groups comprised 54 (74%) and 19 patients (26%), respectively. In multivariate logistic regression analysis, D-dimer (3.6 vs. 0.8 µg/ml) was the only significant independent risk factor for structural disorder (P<0.001). Platelet counts (23.9 vs. 23.5 ×104 /µl), PT-INR (1.05 vs. 1.07), APTT (29.3 vs. 31.7 s), FDP (12 vs. 2.4 µg/ml), and fibrinogen levels (260.6 vs. 231.3 mg/dl) were not associated with structural disorder. These results show that D-dimer is associated with intracranial structural disorder in mild TBI.

Language: en

Keywords

ADULT BRAIN INJURY; BIOMARKERS; HEAD TRAUMA; HUMAN STUDIES; TRAUMATIC BRAIN INJURY