Recombinant Factor VIIa: Decreasing Time to Intervention in Coagulopathic Patients With Severe Traumatic Brain Injury

Background: Treatment of coagulopathy is often needed before neurosurgical intervention in patients with traumatic brain injury (TBI). Typically, this is accomplished with administration of plasma. We hypothesized that the off-label use of recombinant factor VIIa (rFVIIa) to normalize the coagulation profile would allow for earlier intervention than conventional therapy. Methods: The trauma registry was used to identify patients with severe TBI who were admitted during a 4-year period and were coagulopathic at admission (international normalized ratio, INR ≥1.4) and required a neurosurgical procedure. Severe TBI was defined as head abbreviated injury scale (AIS) >3 and admission Glasgow coma score (GCS)