外伤性脑损伤患者二磷酸腺苷抑制的预测模型。

IF 1.5 4区 医学 Q4 NEUROSCIENCES
Caitlyn J Smith, Susanna D Howard, John D Arena, Yohannes G Ghenbot, Zarina S Ali, Dmitry Petrov, Monisha A Kumar, James M Schuster
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引用次数: 0

摘要

引言:外伤性脑损伤(TBI)的凝血功能障碍增加了不良预后的风险。血小板制图(TEG-PM)提供了包括二磷酸腺苷(ADP)抑制在内的凝血参数的动态评估,并可以指导抗血小板逆转。方法:对2015年2月至2024年3月单个一级创伤中心创伤性脑损伤数据库进行横断面研究,建立ADP抑制预测模型。纳入的患者在就诊时CT上有外伤性颅内出血的证据,并进行了TEG-PM测试。排除有抗血小板或抗凝药物使用史的患者。ADP显著抑制≥60%。结果:纳入485例患者。ADP明显抑制的患者更年轻,更有可能发生严重的头部损伤(格拉斯哥昏迷量表3-8)。在以年龄和颅脑损伤严重程度为自变量的多变量logistic回归模型中,严重颅脑损伤显著增加ADP抑制的可能性(优势比2.14,95%置信区间1.28-3.58)。结论:重度颅脑损伤与ADP抑制显著相关的观察结果有助于在没有TEG-PM的情况下识别有血小板功能障碍风险的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
Brain injury
Brain injury 医学-康复医学
CiteScore
3.50
自引率
5.30%
发文量
148
审稿时长
12 months
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.
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