Predictive effect of baseline coagulation function on functional outcomes in patients with traumatic brain injury
Tong Jing
Chen Bo
Bian Zhangya
Ye Xiaofeng
Abstract：Objective To investigate the predictive value of baseline coagulation function on functional outcomes in patients with traumatic brain injury(TBI).Methods Clinical data of 132 TBI patients were analyzed retrospectively.Based on the Functional Independence Measure(FIM)scores,the patients were divided into a poor functional outcome group(n=46)and a good functional outcome group(n=86).General demographic data and laboratory indicators were compared between the two groups.Multivariate logistic regression analysis was used to identify independent factors influencing functional outcomes in TBI patients.Receiver operating characteristic(ROC)curves and decision curve analysis(DCA)were employed to evaluate the predictive performance of baseline coagulation function for functional outcomes.Results The Glasgow Coma Scale(GCS)scores were significantly lower,while Injury Severity Score(ISS)values were higher in the poor functional outcome group compared to the good functional outcome group(P<0.05).Coagulation parameters,including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and D-Dimer(D-D),were all significantly elevated in the poor functional outcome group compared with the good functional outcome group(all P<0.05).Multivariate logistic regression analysis revealed that GCS score(OR=0.451,95%CI:0.234-0.869)was an independent protective factor for poor functional outcomes,while ISS score(OR=2.055,95%CI:1.155-3.656),PT(OR=6.822,95%CI:1.684-27.643),APTT(OR=3.280,95%CI:1.533-7.022),TT(OR=3.379,95%CI:1.562-7.306),and D-D(OR=5.326,95%CI:1.845-15.375)were independent risk factors for poor functional outcomes.ROC curve analysis showed that the area under the curve(AUC)for predicting poor functional outcomes was 0.699 for GCS,0.690 for ISS,0.704 for PT,0.774 for APTT,0.782 for TT,and 0.892 for D-D.The DCA indicated that the model incorporating baseline coagulation function indices provided greater net clinical benefit than models without them.Conclusions GCS score,ISS score,PT,APTT,TT,and D-D are significant predictors of poor functional outcomes in TBI patients.A predictive model combining these factors exhibits high diagnostic accuracy and clinical utility,as evidenced by the DCA.
Keywords：brain injuriestraumaticfunctional outcomecoagulation functiondecision curve
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 208-213 )