Risk factors of traumatic coagulopathy among patients with severe traumatic brain injuries

Fan Zenghui; Kuang Xiaozhong; Gao Min; Xiao Huan; Zhang Xingwen

doi:10.3969/j.issn.1009-4237.2025.06.007

Abstract：Objective To investigate the independent risk factors for traumatic coagulopathy(TIC)in pa-tients with severe traumatic brain injuries(sTBI)who had a Glasgow coma scale scores of 3-8.Methods A retro-spective analysis was conducted on 171 sTBI patients admitted to the Emergency Department of Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University)from Dec.2019 to Dec.2022.This case series included 131 males and 40 females aged 18-83(mean 52.3)years.Injury mechanisms included road traffic injuries(90 cases),falls from height(43 cases),falls(32 cases),and others(6 cases).Patients were di-vided into TIC(76 cases)and non-TIC(95 cases)groups based on the occurrence of TIC within 72 h of admis-sion.General demographic data,laboratory results,and cranial imaging findings were compared between the two groups.Logistic regression analysis was performed to identify independent risk factors for TIC,and receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic efficacy of relevant factors for TIC in sTBI patients.Results No statistically significant difference was observed between the TIC and non-TIC groups in gen-der,age,or surgical intervention(all P>0.05),but significant differences were noted in admission Glasgow coma scale scores,arterial blood pH,blood glucose,lactate(Lac),Helsinki CT score,and proportions of patients with high plasma osmolality,subdural hemorrhage,suprasellar cistern compression/obliteration,midline shift≥5 mm,or hema-toma volume>25 cm3(all P<0.05).Further Logistic regression analysis identified Helsinki CT score≥5.5(OR=1.67,95%CI:1.312-2.103)and high plasma osmolality(OR=5.83,95%CI:2.032-16.733)as independent risk factors for TIC in sTBI(both P<0.05).ROC curve analysis revealed that a Helsinki CT score≥5.5 was the opti-mal cutoff value for predicting TIC in sTBI.Conclusion Helsinki CT score≥5.5 and high plasma osmolality are independent risk factors for TIC in patients with sTBI.