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001-es BibID:	BIBFORM107428
035-os BibID:	(scopus)85130632463 (wos)000730887100003
Első szerző:	Böhm, Julia K.
Cím:	Extended Coagulation Profiling in Isolated Traumatic Brain Injury : a CENTER-TBI Analysis / Böhm Julia K., Schaeben Victoria, Schäfer Nadine, Güting Helge, Lefering Rolf, Thorn Sophie, Schöchl Herbert, Zipperle Johannes, Grottke Oliver, Rossaint Rolf, Stanworth Simon, Curry Nicola, Maegele Marc, CENTER-TBI Participants and Investigators
Dátum:	2021
ISSN:	1541-6933
Megjegyzések:	Abstract Background: Trauma-induced coagulopathy in traumatic brain injury (TBI) remains associated with high rates of complications, unfavorable outcomes, and mortality. The underlying mechanisms are largely unknown. Embedded in the prospective multinational Collaborative European Neurotrauma Efectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, coagulation profles beyond standard conventional coagulation assays were assessed in patients with isolated TBI within the very early hours of injury. Methods: Results from blood samples (citrate/EDTA) obtained on hospital admission were matched with clinical and routine laboratory data of patients with TBI captured in the CENTER-TBI central database. To minimize confound ing factors, patients with strictly isolated TBI (iTBI) (n=88) were selected and stratifed for coagulopathy by routine international normalized ratio (INR): (1) INR<1.2 and (2) INR?1.2. An INR>1.2 has been well adopted over time as a threshold to defne trauma-related coagulopathy in general trauma populations. The following parameters were evaluated: quick's value, activated partial thromboplastin time, fbrinogen, thrombin time, antithrombin, coagulation factor activity of factors V, VIII, IX, and XIII, protein C and S, plasminogen, D-dimer, fbrinolysis-regulating parameters (thrombin activatable fbrinolysis inhibitor, plasminogen activator inhibitor 1, antiplasmin), thrombin generation, and fbrin monomers. Results: Patients with iTBI with INR?1.2 (n=16) had a high incidence of progressive intracranial hemorrhage associ ated with increased mortality and unfavorable outcome compared with patients with INR<1.2 (n=72). Activity of coagulation factors V, VIII, IX, and XIII dropped on average by 15?20% between the groups whereas protein C and S levels dropped by 20%. With an elevated INR, thrombin generation decreased, as refected by lower peak height and endogenous thrombin potential (ETP), whereas the amount of fbrin monomers increased. Plasminogen activity signifcantly decreased from 89% in patients with INR<1.2 to 76% in patients with INR?1.2. Moreover, D-dimer levels signifcantly increased from a mean of 943 mg/L in patients with INR<1.2 to 1,301 mg/L in patients with INR?1.2
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk CENTER-TBI Coagulopathy Fibrin monomers Progressive intracranial hemorrhage Thrombin generation Traumatic brain injur
Megjelenés:	Neurocritical Care. - 36 : 3 (2021), p. 927-941. -
További szerzők:	Schaeben, Victoria Schäfer, Nadine Güting, Helge Lefering, Rolf Thorn, Sophie Schöchl, Herbert Zipperle, Johannes Grottke, Oliver Rossaint, Rolf Stanworth, Simon Curry, Nicola Maegele, Marc Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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