Effects of different application timing of tranexamic acid on coagulation function and prognosis of patients with emergency traumatic brain injury

Bi Zong-fu; Chang Zi-qiang

doi:10.3969/j.issn.1672-8157.2024.06.009

Abstract：Objective To investigate the effects of different application timing of tranexamic acid on coagulation function and prognosis of patients with emergency traumatic brain injury. Methods According to different timing of administration,80 patients with traumatic brain injury admitted to Shunyi District Hospital from January 2019 to December 2022 were enrolled and divided into the≤1 h injection group (n=50,tranexamic acid injection within 1h after injury) and the 1-3 h injection group (n=30,tranexamic acid injection within 1-3h after injury). The clinical indexes and coagulation function in the two groups were compared before and after treatment. The prognostic effect was evaluated after treatment. The incidence of complications in the two groups was statistical-ly analyzed. Results The hematoma volume in the ≤1 h injection group was less than that in the 1-3 h injection group ((20.15±3.16) mL vs (25.17±3.84) mL) whereas the hemostasis time and stay time in intensive care unit (ICU) were shorter than those in the 1-3 h injection group ((48.15±6.18) min vs (83.23±7.31) min,(3.18±1.08) d vs (5.37±1.14) d),the differences were statistically sig-nificant (t=6.340,22.936,8.600,all P<0.05). After treatment,prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen (FIB) were decreased in both groups and they were lower in the ≤1 h injection group than in the 1-3 h injection group ((10.37±1.18) s vs (11.16±1.14) s,(31.07±2.16) s vs (34.36±2.48) s,(3.05±0.31) g·L-1 vs (3.53±0.58) g·L-1),showing statistically significant differences (t=2.936,6.237,4.827,all P<0.05). After 1 month of treatment,proportion of Glasgow outcome scale (GOS) score of 5 points was higher but proportion of GOS score of 1 points lower in the ≤1 h injection group than in the 1-3 h injection group,the differences were statistically significant (x2=4.832,10.811,both P<0.05). The incidence of complications in the ≤ 1 h injection group was lower than that in the 1-3 h injection group and the difference was statistically significant (12.00％ (6/50) vs 40.00％ (12/30),x2=8.430,P<0.05). Conclusion The injection of tranexamic acid within 1h after injury can effectively improve coagulation function,relieve bleeding status,reduce incidence of complications and promote prognosis recovery in patients with emergency traumatic brain injury.