• Shahriar Zehtabchi, Samara Soghoian, Yiju Liu, Kristin Carmody, Lekha Shah, Brian Whittaker, and Richard Sinert.
• Department of Emergency Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, United States. szehtabchi@yahoo.com
• Resuscitation. 2008 Jan 1;76(1):52-6.

UnlabelledThe emergence of prothrombotic agents (e.g. activated factor VII) to treat traumatic brain injury (TBI) requires a better understanding of the association of coagulopathy with isolated head injury (IHI).ObjectiveTo investigate the association of IHI and coagulopathy.MethodsProspective, observational study in an urban level I trauma center.Inclusion CriteriaAdult (> or = 13 years of age) patients with IHI.Exclusion Criteriapatients with known coagulopathies or on anticoagulant therapy.Predictor VariablesTBI (head abbreviated injury severity score > 2, or brain hematoma on CT scan), age, gender, mechanism of injury, Glasgow Coma Score (GCS), and loss of consciousness (LOC).Outcome Variablescoagulopathy defined as elevated International Normalized Ratio (INR > 1.3) or activated partial thromboplastin time (PTT) greater than 34 s. We divided IHI subjects into two groups of patients with and without TBI.Statistical AnalysisFisher's exact test and Mann-Whitney U were used to compare data where appropriate (alpha: 0.05, two-tailed).ResultsFrom July 2005 to December 2006, 276 patients with IHI were studied. The median age was 35 years (interquartile range: 25-52) with a 79% male predominance and 88% blunt trauma. Eight percent (95% CI, 5-12%) of patients had coagulopathy. The rate of coagulopathy in TBI patients (17%) was significantly higher than non-TBI patients (6%) (11% difference, 95% CI, 3-20%]. The relative risk of coagulopathy in TBI patients was 2.9 (95% CI, 1.3-6.6).ConclusionCoagulopathy as defined by elevated INR and/or PTT is associated with TBI after isolated head injury.

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