Hypocoagulability in Traumatic Brain Injury as Measured by Traditional Means and Thrombelastography

Abstract

Background: Conflicting data exist regarding the association of traumatic brain injury (TBI) with coagulopathy as measured by conventional coagulation testing (CCT).

Use of Thromboelastography in the Evaluation and Management of Patients With Traumatic Brain Injury: A Systematic Review and Meta-Analysis

“…Folkerson et al (38) found that coagulopathy after penetrating TBI defined by abnormal R-TEG parameters or platelet count less than 150,000 was independently associated with mortality. Sixta et al (25) found a similar correlation after isolated TBI (80% blunt mechanism). Rao et al (28) noted that increased LY-30 was associated with a need for a neurosurgical procedure and increased K-time was associated with increased mortality.…”

“…Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram. Additional records identified by other sources included the following: Baksaas-Aasen et al (14), Furay et al (24), Gonzalez et al (13), Sixta et al (25), Kay et al (26), Kumar et al (27), Rao et al (28), and Webb et al (29). TBI = traumatic brain injury, TEG = thromboelastography, VHA = viscoelastic hemostatic assay.…”

“…lww.com/CCX/A764). Twelve studies were also considered for qualitative synthesis of thromboelastography and TEG-PM assays results for prognostication in TBI patients for a range of clinical outcomes including mortality, the need for neurosurgical intervention, and bleeding complications (25,26,28,38,41,42,46,(48)(49)(50)(51)(52). TEG-PM was generally more reliable in these predictions than standard thromboelastography, particularly regarding mortality.…”