Talving et al identified risk factors associated with coagulopathy associated with traumatic brain injury (TBI). These findings can help to identify a patient who may benefit from closer monitoring for this complication. The authors are from the University of Southern California in Los Angeles.
Parameters:
(1) Glasgow coma score (GCS)
(2) systolic blood pressure on admission
(3) injury severity score (ISS)
(4) cerebral edema
(5) subarachnoid hemorrhage
(6) midline shift
Parameter |
Finding |
Points |
Glasgow coma score |
9 to 15 |
0 |
|
3 to 8 |
1 |
systolic blood pressure on admission |
>= 90 mm Hg |
0 |
|
< 90 mm Hg |
1 |
ISS |
< 16 |
0 |
|
>= 16 |
1 |
cerebral edema |
absent |
0 |
|
present |
1 |
subarachnoid hemorrhage |
absent |
0 |
|
present |
1 |
midline shift |
absent |
0 |
|
present |
1 |
total number of risk factors =
= SUM(points for all 6 risk factors)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 6
• The risk of TBI-associated coagulopathy increases with the number of risk factors present.
Additional findings:
(1) severe traumatic brain injury (AIS >= 3)
(2) penetrating brain injury
Specialty: Hematology Oncology, Clinical Laboratory, Surgery, general, Surgery, orthopedic, Emergency Medicine