Table 1.
Characteristics of patients with iTBI stratified by INR (n = 88)
| INR <1.2 (n = 72) | INR ≥1.2 (n = 16) | |
|---|---|---|
| Demographics | ||
| Age, median (IQR) (years) | 41.0 (30 to 57) | 27.0 (22 to 54) |
| Age ≥ 75, n (%) | 5 (6.9) | NA |
| Male sex, n (%) | 48 (66.6) | 12 (75) |
| Injury characteristics, n (%) | ||
| Blunt TBI | 65 (90.3) | 15 (93.8) |
| AIS 2 | 6 (8.3) | 1 (6.3) |
| AIS 3 | 27 (37.5) | 1 (6.3) |
| AIS 4 | 21 (29.2) | 6 (37.5) |
| AIS 5 | 18 (25) | 8 (50) |
| Injuries identified on initial CT scan, n (%) | ||
| Diffuse axonal injury | 9 (12.5) | 2 (12.5) |
| Extradural hematoma | 15 (20.8) | 4 (25) |
| Subdural hematoma | 28 (38.8) | 7 (43.7) |
| Subarachnoid hemorrhage | 34 (47.2) | 8 (50) |
| Midline shift | 12 (16.7) | 6 (37.5)* |
| Basal cistern compression | 6 (8.3) | 2 (12.5) |
| Depressed skull fracture | 7 (9.7) | 3 (18.8) |
| Severe contusion | 2 (2.7) | 2 (12.5) |
| Medical presentation at admission (ED) | ||
| GCS, median (IQR) | 14.0 (10.0 to 15.0) | 12.0 (7.5 to 15.0) |
| SBP, median (IQR) (mm Hg) | 134.0 (123 to 150) | 135.5 (113 to 163) |
| Heart rate, median (IQR) (bpm) | 84.0 (75 to 97) | 82.0 (68 to 90) |
| Temperature, median (IQR) (°C) | 36.4 (35.8 to 36.9) | 36.0 (35.6 to 36.4) |
| Scheduled for emergency surgical intervention, n (%) | 11 (15.3) | 2 (12.5) |
| Neuroworsening, n (%) | 8 (11.1) | 3 (18.8) |
| Parameter for tissue injury and hypoperfusion, median (IQR) | ||
| Base excess (mmol/L) | −1.1 (−2.9 to 0.55) | −2.7 (−3.7 to −0.9) |
| Shock index | 0.61 (0.52 to 0.71) | 0.64 (0.48 to 0.73) |
| Parameter for hemodilution, median (IQR) | ||
| Platelet count (per nL) | 220.5 (181.5 to 273.5) | 211.5 (177.8 to 235.3) |
| Hemoglobin (g/dL) | 13.9 (12.8 to 14.5) | 13.4 (12.1 to 14.4) |
| Hematocrit | 41.0 (38.0 to 44.0) | 44.0 (37.7 to 45.7)* |
| ED therapy, n (%) | ||
| Blood products (e.g., RBC, FFP, PC, WB) | NA | NA |
| Hemostatic agents | ||
| TXA | 2 (2.7) | 1 (6.3) |
| Outcomes | ||
| Death (overall), n (%) | 7 (9.7) | 3 (18.8) |
| GOS-E (6 months), median (IQR) | 7 (6 to 8) | 5 (2 to 7.5) |
Neuroworsening was defined as follows: (1) a decrease in the GCS motor score of 2 or more points, (2) a new loss of pupillary reactivity or development of pupillary asymmetry ≥2 mm, or (3) deterioration in neurological or CT status sufficient to warrant immediate medical or surgical intervention. Shock index was calculated as follows: heart rate (bpm) divided by SBP (mm Hg). Patients with iTBI with AISBrain 6 were not included.
AIS Abbreviated Injury Scale, aPTT activated partial thromboplastin time, CT computed tomography, ED emergency department, FFP fresh frozen plasma, GCS Glasgow Coma Scale, GOS-E Glasgow Outcome Score Extended, INR international normalized ratio, iTBI isolated traumatic brain injury, NA not available, PC platelet concentrate, PCC prothrombin complex concentrate, RBC red blood cells, SBP systolic blood pressure, TXA tranexamic acid, WB whole blood
*P < 0.05, **P < 0.001, ***P < 0.0001: statistically significant differences between patients with iTBI with INR <1.2 and patients with iTBI with INR ≥1.2.