Abstract

Background and Objective

The imbalanced hemostatic equilibrium caused by brain tissue or vessel damage underlies the pathophysiology of traumatic brain injury (TBI)-induced coagulopathy, and cranial computed tomography (CT) is the gold standard for evaluating brain injury. The present study aimed to explore the correlation between quantitative cranial CT parameters and coagulopathy after TBI.

Methods

We retrospectively collected the medical records of TBI patients with extracranial abbreviated injury scale (AIS) scores <3 who were admitted to our institution. The quantitative cranial CT parameters of patients with and without coagulopathy were compared, and univariate correlation analysis between CT parameters and coagulation subtest values and platelet counts was performed. The predictors for each subtest of coagulation function were probed by multivariate regression.

Results

TBI patients with coagulopathy had a larger intracerebral haematoma/contusion (ICH/C) volume (p < 0.001), a higher incidence of compressed basal cisterns (p = 0.015), a higher Graeb score (p < 0.001) and subarachnoid haematoma (Fisher’s scaling score) (p = 0.019) than those without coagulopathy. IH/C volume was identified as an independent risk factor for predicting coagulopathy. ICH/C volume showed a significantly positive correlation with APTT (Pearson’s correlation = 0.333, p < 0.001), while a significant negative correlation with PLT (Pearson’s correlation = − 0.312, p < 0.001).

Conclusion

ICH/C volume was a main quantitative cranial CT parameter for predicting coagulopathy, suggesting that parenchymal brain damage and vessel injury were closely associated with coagulopathy after TBI.

中文翻译：

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计算机断层扫描参数与孤立性创伤性脑损伤中的凝血障碍相关

摘要

背景与目的

由脑组织或血管损伤引起的不平衡止血平衡是创伤性脑损伤 (TBI) 引起的凝血病的病理生理学基础，而颅骨计算机断层扫描 (CT) 是评估脑损伤的金标准。本研究旨在探讨颅脑 CT 定量参数与 TBI 后凝血功能障碍之间的相关性。

方法

我们回顾性地收集了我们机构收治的颅外损伤量表（AIS）评分<3的TBI患者的医疗记录。比较有无凝血病患者的颅脑CT定量参数，并对CT参数与凝血分试验值和血小板计数进行单因素相关性分析。通过多元回归探讨凝血功能的每个子测试的预测因子。

结果

患有凝血障碍的 TBI 患者有较大的脑内血肿/挫伤 (ICH/C) 体积 ( p  < 0.001)、压缩基底池的发生率较高 ( p  = 0.015)、较高的 Graeb 评分 ( p  < 0.001) 和蛛网膜下腔血肿 (Fisher's量表评分）（p  = 0.019）比没有凝血障碍的人。IH/C 体积被确定为预测凝血障碍的独立危险因素。ICH/C 体积与 APTT 呈显着正相关（Pearson 相关 = 0.333，p  < 0.001），而与 PLT 呈显着负相关（Pearson 相关 = - 0.312，p  < 0.001）。

结论

ICH/C 体积是预测凝血功能障碍的主要颅 CT 定量参数，提示脑实质损伤和血管损伤与 TBI 后凝血功能障碍密切相关。