Rapid Thromboelastography Identifies Coagulopathy and Predicts Poor Outcomes in Severe Traumatic Brain Injury

Area of Science:

• Neuroscience
• Hematology
• Trauma Surgery

Background:

• Traumatic brain injury (TBI) can cause coagulopathy, increasing mortality risk.
• Viscoelastic methods like rapid Thromboelastography (r-TEG) show promise for precise coagulopathy assessment.
• Identifying coagulopathic changes is crucial for managing patients with severe TBI (sTBI).

Purpose of the Study:

• To evaluate the utility of r-TEG in identifying and categorizing coagulopathy in patients with sTBI.
• To compare clinical and laboratory parameters, as well as outcomes, between different r-TEG-defined coagulation states.

Main Methods:

• A single-center, cross-sectional study included 105 adult patients with sTBI (Glasgow Coma Scale ≤8).
• r-TEG was performed, and patients were categorized into hypercoagulable, hypocoagulable, or normal groups.
• Clinical data, laboratory results, and mortality were analyzed and compared across groups.

Main Results:

• Coagulopathy was identified in 42% of sTBI patients (36% hypocoagulable, 6% hypercoagulable).
• Significant differences in r-TEG parameters (R time, K time, alpha angle, MA, etc.) were observed between coagulation groups.
• Mortality was higher in patients with coagulopathy (hypocoagulable or hypercoagulable) compared to those with normal coagulation.

Conclusions:

• r-TEG is a valuable tool for detecting coagulopathy in the sTBI population.
• The presence of coagulopathy, as identified by r-TEG, is associated with increased mortality in severe TBI.
• r-TEG-derived parameters and clinical factors like GCS and SBP predict mortality in sTBI.