Clinically suspected coagulopathy in blunt head trauma

Area of Science:

• Emergency Medicine
• Neurosurgery
• Radiology

Background:

• Patients with head injuries and abnormal coagulation face higher risks of brain damage.
• Clinical suspicion of coagulopathy is a key indicator in head trauma assessment.

Purpose of the Study:

• To determine the association between clinical suspicion of coagulopathy and intracranial injury (ICI) in blunt head trauma patients.
• To evaluate the impact of suspected coagulopathy on injury severity and subsequent medical interventions.

Main Methods:

• Prospective evaluation of patients from the NEXUS II blunt head injury study.
• Analysis of head computed tomography (CT) scan results to identify ICI.
• Comparison of ICI prevalence and intervention rates between patients with and without suspected coagulopathy.

Main Results:

• Significant ICI was found in 9.3% of patients with suspected coagulopathy versus 4.7% without.
• Patients with suspected coagulopathy and "therapeutically inconsequential" CT findings underwent interventions at a higher rate (71% vs. 4%).

Conclusions:

• Clinical suspicion of coagulopathy, irrespective of lab results, correlates with increased significant ICI after blunt head trauma.
• Head CT scanning should be considered based on clinical suspicion of coagulopathy in head trauma evaluations.