在创伤性脑损伤引起的凝血病上,受伤前抗凝剂的时间依赖性协会:一项回顾性,多中心的队列研究
Kazuya Matsuo1,2, Hideo Aihara3,4, Eiichi Suehiro5
1Department of Neurosurgery, Hyogo Emergency Medical Center and Kobe Red Cross Hospital, Kobe, Hyogo, Japan.
Neurosurgery
|October 24, 2024
概括
在创伤性脑损伤 (TBI) 患者的伤害前抗凝剂会影响凝血测试. D-二次体可能不反映TBI的严重程度,但升高的PT-INR和延长的APTT表明需要早期逆转抗凝剂.
科学领域:
- 神经创伤是一种神经创伤.
- 血液学 血液学 血液学
- 老年医学 老年医学
背景情况:
- 伤害前抗凝剂对TBI凝血病的影响尚不清楚.
- 假设:伤害前的抗凝剂会影响TBI凝血病的进展.
研究的目的:
- 在TBI后24小时内检查伤害前抗凝剂与凝血参数的关联.
- 研究对D-二聚体,PT-INR,APTT,纤维素素和血小板数量的影响.
主要方法:
- 从日本注册 (2019-2021) 中对TBI患者 (≥65岁) 的回顾性分析.
- 在TBI后的5个时间段中分析了凝血参数.
- 使用协同变量分析,控制10个临床因素.
主要成果:
- 在545名患者中,16%的患者接受了受伤前的抗凝药.
- 抗凝血组的TBI严重性得分更高,结果更差.
- 在服用抗凝血药物的患者中观察到较低的D-二聚体和较高的纤维素原.
- 在伤害前抗凝剂和D-二次体 (2-24小时),APTT (1-24小时) 和PT-INR (0-24小时) 之间发现了显著的关联.
结论:
- 在服用抗凝血药的患者中,D-二聚物水平可能低估了TBI的严重程度.
- 伤害前的抗凝剂与TBI后的延长PT-INR和APTT有关.
- 强调需要在这些患者迅速逆转抗凝剂.
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