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Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury
BACKGROUND: Coagulopathy and old age have been associated with poor outcomes in traumatic brain injury (TBI) patients; however, the relationships of coagulopathy and age with the acute phase of TBI remain unclear. We hypothesized that coagulation/fibrinolytic abnormalities are more severe in older p...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609444/ https://www.ncbi.nlm.nih.gov/pubmed/28966820 http://dx.doi.org/10.4103/sni.sni_56_17 |
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author | Nakae, Ryuta Yokobori, Shoji Takayama, Yasuhiro Kuwamoto, Kentaro Naoe, Yasutaka Yokota, Hiroyuki |
author_facet | Nakae, Ryuta Yokobori, Shoji Takayama, Yasuhiro Kuwamoto, Kentaro Naoe, Yasutaka Yokota, Hiroyuki |
author_sort | Nakae, Ryuta |
collection | PubMed |
description | BACKGROUND: Coagulopathy and old age have been associated with poor outcomes in traumatic brain injury (TBI) patients; however, the relationships of coagulopathy and age with the acute phase of TBI remain unclear. We hypothesized that coagulation/fibrinolytic abnormalities are more severe in older patients in the acute phase of TBI and may explain, in part, their poor outcome. METHODS: We analyzed the relationship between coagulation/fibrinolytic parameters and age in the acute phase of TBI by retrospectively evaluating 274 patients with initial blood samples obtained no more than 1 hour after injury. Measurement of platelet count, prothrombin time, activated partial thromboplastin time, plasma levels of fibrinogen, and D-dimer was done in the emergency department on arrival as well as 3, 6, and 12 hours following injury. Values were compared between patients aged 16–55 years (group 1) and those aged older than 55 years (group 2) with an Abbreviated Injury Score (AIS)-head of 3–5 to identify any relationship between these parameters and age. RESULTS: When groups 1 and 2 were matched for AIS-head, plasma levels of D-dimer in group 2 were significantly higher than those in group 1 from hospital admission to 12 hours after injury. The Glasgow Outcome Scale scores at 3 months post-injury of group 2 with AIS 4 and 5 were significantly lower than those of group 1 (both P < 0.0001). CONCLUSIONS: Fibrinolytic abnormalities are more severe in older acute-phase TBI patients, which may be a factor associated with their poor prognosis. |
format | Online Article Text |
id | pubmed-5609444 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-56094442017-09-29 Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury Nakae, Ryuta Yokobori, Shoji Takayama, Yasuhiro Kuwamoto, Kentaro Naoe, Yasutaka Yokota, Hiroyuki Surg Neurol Int Trauma: Original Article BACKGROUND: Coagulopathy and old age have been associated with poor outcomes in traumatic brain injury (TBI) patients; however, the relationships of coagulopathy and age with the acute phase of TBI remain unclear. We hypothesized that coagulation/fibrinolytic abnormalities are more severe in older patients in the acute phase of TBI and may explain, in part, their poor outcome. METHODS: We analyzed the relationship between coagulation/fibrinolytic parameters and age in the acute phase of TBI by retrospectively evaluating 274 patients with initial blood samples obtained no more than 1 hour after injury. Measurement of platelet count, prothrombin time, activated partial thromboplastin time, plasma levels of fibrinogen, and D-dimer was done in the emergency department on arrival as well as 3, 6, and 12 hours following injury. Values were compared between patients aged 16–55 years (group 1) and those aged older than 55 years (group 2) with an Abbreviated Injury Score (AIS)-head of 3–5 to identify any relationship between these parameters and age. RESULTS: When groups 1 and 2 were matched for AIS-head, plasma levels of D-dimer in group 2 were significantly higher than those in group 1 from hospital admission to 12 hours after injury. The Glasgow Outcome Scale scores at 3 months post-injury of group 2 with AIS 4 and 5 were significantly lower than those of group 1 (both P < 0.0001). CONCLUSIONS: Fibrinolytic abnormalities are more severe in older acute-phase TBI patients, which may be a factor associated with their poor prognosis. Medknow Publications & Media Pvt Ltd 2017-09-06 /pmc/articles/PMC5609444/ /pubmed/28966820 http://dx.doi.org/10.4103/sni.sni_56_17 Text en Copyright: © 2017 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Trauma: Original Article Nakae, Ryuta Yokobori, Shoji Takayama, Yasuhiro Kuwamoto, Kentaro Naoe, Yasutaka Yokota, Hiroyuki Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury |
title | Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury |
title_full | Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury |
title_fullStr | Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury |
title_full_unstemmed | Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury |
title_short | Age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury |
title_sort | age-related differences in fibrinolytic parameters in patients with acute traumatic brain injury |
topic | Trauma: Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609444/ https://www.ncbi.nlm.nih.gov/pubmed/28966820 http://dx.doi.org/10.4103/sni.sni_56_17 |
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