Back to Search
Start Over
A retrospective study of the effect of fibrinogen levels during fresh frozen plasma transfusion in patients with traumatic brain injury.
- Source :
-
Acta neurochirurgica [Acta Neurochir (Wien)] 2019 Sep; Vol. 161 (9), pp. 1943-1953. Date of Electronic Publication: 2019 Jul 15. - Publication Year :
- 2019
-
Abstract
- Background: The association between traumatic brain injury (TBI) and coagulopathy is well established. While coagulopathy prophylaxis in TBI involves replenishing coagulation factors with fresh frozen plasma (FFP), its effectiveness is controversial. We investigated the relationship between plasma fibrinogen concentration 3 h after initiating FFP transfusion and outcomes and evaluated the correlation with D-dimer levels at admission.<br />Methods: We retrospectively examined data from 380 patients with severe isolated TBI with blood samples collected a maximum of 1 h following injury. Plasma fibrinogen and D-dimer concentrations were obtained at admission, and plasma fibrinogen concentration was again assessed 3-4 h following injury. The patients were divided into two groups based on whether or not they received FFP transfusion. Patients were also divided into subgroups according their fibrinogen level: ≥ 150 mg/dL (high-fibrinogen subgroup) or < 150 mg/dL (low-fibrinogen subgroup) 3 h after injury. Demographic, clinical, radiological and laboratory data were compared between these subgroups.<br />Results: Glasgow Outcome Scale (GOS) scores at discharge and 3 months after injury were significantly lower in the FFP transfusion group than in the FFP non-transfusion group. Among patients who received FFP, GOS scores at discharge and 3 months after injury were significantly higher in the high-fibrinogen subgroup than in the low-fibrinogen subgroup. Elevated admission D-dimer predicted subsequent fibrinogen decrease.<br />Conclusions: In FFP transfusion, fibrinogen level ≥ 150 mg/dL 3 h after injury was associated with better outcomes in TBI patients. Assessing the admission D-dimer and tracking the fibrinogen are crucial for optimal coagulopathy prophylaxis in TBI patients.
- Subjects :
- Adult
Aged
Blood Coagulation Disorders
Blood Coagulation Tests
Female
Fibrin Fibrinogen Degradation Products
Glasgow Outcome Scale
Humans
Male
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Treatment Outcome
Blood Transfusion methods
Brain Injuries, Traumatic blood
Brain Injuries, Traumatic therapy
Fibrinogen analysis
Plasma chemistry
Subjects
Details
- Language :
- English
- ISSN :
- 0942-0940
- Volume :
- 161
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Acta neurochirurgica
- Publication Type :
- Academic Journal
- Accession number :
- 31309303
- Full Text :
- https://doi.org/10.1007/s00701-019-04010-3