Caitlyn J Smith, Susanna D Howard, John D Arena, Yohannes G Ghenbot, Zarina S Ali, Dmitry Petrov, Monisha A Kumar, James M Schuster
{"title":"外伤性脑损伤患者二磷酸腺苷抑制的预测模型。","authors":"Caitlyn J Smith, Susanna D Howard, John D Arena, Yohannes G Ghenbot, Zarina S Ali, Dmitry Petrov, Monisha A Kumar, James M Schuster","doi":"10.1080/02699052.2025.2502425","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Coagulopathy in the setting of traumatic brain injury (TBI) increases the risk of poor outcomes. Thromboelastography with platelet mapping (TEG-PM) provides a dynamic assessment of clotting parameters including adenosine diphosphate (ADP) inhibition and can guide antiplatelet reversal.</p><p><strong>Methods: </strong>A cross-sectional study of a single Level I Trauma Center traumatic brain injury database from February 2015 to March 2024 was conducted to develop a prediction model of ADP inhibition. Included patients had evidence of traumatic intracranial hemorrhage on CT at the time of presentation and underwent TEG-PM testing. Patients with a history of antiplatelet or anticoagulant use were excluded. Significant ADP inhibition was defined as ≥ 60%.</p><p><strong>Results: </strong>485 patients were included. Patients with significant ADP inhibition were younger and more likely to have a severe head injury (Glasgow Coma Scale 3-8). In a multivariate logistic regression model including age and head injury severity as independent variables, severe head injury significantly increased the likelihood of ADP inhibition (odds ratio 2.14, 95% confidence interval 1.28-3.58).</p><p><strong>Conclusion: </strong>The observation that severe head injury was significantly associated with ADP inhibition could help identify patients at risk for platelet dysfunction in settings without TEG-PM.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1-7"},"PeriodicalIF":1.5000,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A prediction model of adenosine diphosphate inhibition among traumatic brain injury patients.\",\"authors\":\"Caitlyn J Smith, Susanna D Howard, John D Arena, Yohannes G Ghenbot, Zarina S Ali, Dmitry Petrov, Monisha A Kumar, James M Schuster\",\"doi\":\"10.1080/02699052.2025.2502425\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Coagulopathy in the setting of traumatic brain injury (TBI) increases the risk of poor outcomes. Thromboelastography with platelet mapping (TEG-PM) provides a dynamic assessment of clotting parameters including adenosine diphosphate (ADP) inhibition and can guide antiplatelet reversal.</p><p><strong>Methods: </strong>A cross-sectional study of a single Level I Trauma Center traumatic brain injury database from February 2015 to March 2024 was conducted to develop a prediction model of ADP inhibition. Included patients had evidence of traumatic intracranial hemorrhage on CT at the time of presentation and underwent TEG-PM testing. Patients with a history of antiplatelet or anticoagulant use were excluded. Significant ADP inhibition was defined as ≥ 60%.</p><p><strong>Results: </strong>485 patients were included. Patients with significant ADP inhibition were younger and more likely to have a severe head injury (Glasgow Coma Scale 3-8). In a multivariate logistic regression model including age and head injury severity as independent variables, severe head injury significantly increased the likelihood of ADP inhibition (odds ratio 2.14, 95% confidence interval 1.28-3.58).</p><p><strong>Conclusion: </strong>The observation that severe head injury was significantly associated with ADP inhibition could help identify patients at risk for platelet dysfunction in settings without TEG-PM.</p>\",\"PeriodicalId\":9082,\"journal\":{\"name\":\"Brain injury\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-05-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brain injury\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02699052.2025.2502425\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brain injury","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02699052.2025.2502425","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
A prediction model of adenosine diphosphate inhibition among traumatic brain injury patients.
Introduction: Coagulopathy in the setting of traumatic brain injury (TBI) increases the risk of poor outcomes. Thromboelastography with platelet mapping (TEG-PM) provides a dynamic assessment of clotting parameters including adenosine diphosphate (ADP) inhibition and can guide antiplatelet reversal.
Methods: A cross-sectional study of a single Level I Trauma Center traumatic brain injury database from February 2015 to March 2024 was conducted to develop a prediction model of ADP inhibition. Included patients had evidence of traumatic intracranial hemorrhage on CT at the time of presentation and underwent TEG-PM testing. Patients with a history of antiplatelet or anticoagulant use were excluded. Significant ADP inhibition was defined as ≥ 60%.
Results: 485 patients were included. Patients with significant ADP inhibition were younger and more likely to have a severe head injury (Glasgow Coma Scale 3-8). In a multivariate logistic regression model including age and head injury severity as independent variables, severe head injury significantly increased the likelihood of ADP inhibition (odds ratio 2.14, 95% confidence interval 1.28-3.58).
Conclusion: The observation that severe head injury was significantly associated with ADP inhibition could help identify patients at risk for platelet dysfunction in settings without TEG-PM.
期刊介绍:
Brain Injury publishes critical information relating to research and clinical practice, adult and pediatric populations. The journal covers a full range of relevant topics relating to clinical, translational, and basic science research. Manuscripts address emergency and acute medical care, acute and post-acute rehabilitation, family and vocational issues, and long-term supports. Coverage includes assessment and interventions for functional, communication, neurological and psychological disorders.