Adenosine diphosphate platelet dysfunction on thromboelastogram is independently associated with increased morality in traumatic brain injury

M. J. Daley, Z. Enright, J. Nguyen, S. Ali, A. Clark, J. D. Aydelotte, P. G. Teixeira, T. B. Coopwood, C. V R Brown

Research output: Contribution to journalArticle

Abstract

Purpose: The purpose of this study is to determine if adenosine diphosphate (ADP) platelet dysfunction on thromboelastogram (TEG) is associated with increased in-hospital mortality in patients with head trauma. The hypothesis is that ADP dysfunction is associated with increased mortality. Methods: This retrospective review evaluated trauma patients admitted to a level 1 trauma center from February 2011 to October 2013 who received a TEG. Patients were included if the TEG was drawn within the first 24 h of admission and the head abbreviated injury score was greater than or equal to three. Patients were categorized as severe ADP dysfunction if the degree of ADP inhibition on TEG exceeded 60 %. Results: A total of 90 patients were included (no ADP dysfunction n = 37; ADP dysfunction n = 53). Initial Glasgow Coma Scale [GCS (12 ± 4 vs. 11 ± 5; p = 0.26)] and use of pre-injury antiplatelet agents (30 vs. 28 %; p = 0.88) were similar. Patients with ADP dysfunction on TEG had a higher in-hospital mortality rate (8 vs. 32 %; p < 0.01). ADP dysfunction was independently associated with in-hospital mortality upon fixed logistic regression (OR 6.2; 95 % CI 1.2–33) while controlling for age, gender, hypotension, pre-injury antiplatelet agents, GCS and Injury Severity Score. Conclusion: ADP dysfunction on TEG is associated with increased mortality in patients with traumatic brain injury.

Original languageEnglish (US)
Pages (from-to)105-111
Number of pages7
JournalEuropean Journal of Trauma and Emergency Surgery
Volume43
Issue number1
DOIs
StatePublished - Feb 1 2017

Fingerprint

Adenosine Diphosphate
Brain Injuries
Blood Platelets
Hospital Mortality
Mortality
Wounds and Injuries
Platelet Aggregation Inhibitors
Craniocerebral Trauma
Glasgow Coma Scale
Injury Severity Score
Trauma Centers
Hypotension
Logistic Models
Inhibition (Psychology)

Keywords

  • Platelet dysfunction
  • TEG
  • Thromboelastogram
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine

Cite this

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title = "Adenosine diphosphate platelet dysfunction on thromboelastogram is independently associated with increased morality in traumatic brain injury",
abstract = "Purpose: The purpose of this study is to determine if adenosine diphosphate (ADP) platelet dysfunction on thromboelastogram (TEG) is associated with increased in-hospital mortality in patients with head trauma. The hypothesis is that ADP dysfunction is associated with increased mortality. Methods: This retrospective review evaluated trauma patients admitted to a level 1 trauma center from February 2011 to October 2013 who received a TEG. Patients were included if the TEG was drawn within the first 24 h of admission and the head abbreviated injury score was greater than or equal to three. Patients were categorized as severe ADP dysfunction if the degree of ADP inhibition on TEG exceeded 60 %. Results: A total of 90 patients were included (no ADP dysfunction n = 37; ADP dysfunction n = 53). Initial Glasgow Coma Scale [GCS (12 ± 4 vs. 11 ± 5; p = 0.26)] and use of pre-injury antiplatelet agents (30 vs. 28 %; p = 0.88) were similar. Patients with ADP dysfunction on TEG had a higher in-hospital mortality rate (8 vs. 32 %; p < 0.01). ADP dysfunction was independently associated with in-hospital mortality upon fixed logistic regression (OR 6.2; 95 % CI 1.2–33) while controlling for age, gender, hypotension, pre-injury antiplatelet agents, GCS and Injury Severity Score. Conclusion: ADP dysfunction on TEG is associated with increased mortality in patients with traumatic brain injury.",
keywords = "Platelet dysfunction, TEG, Thromboelastogram, Traumatic brain injury",
author = "Daley, {M. J.} and Z. Enright and J. Nguyen and S. Ali and A. Clark and Aydelotte, {J. D.} and Teixeira, {P. G.} and Coopwood, {T. B.} and Brown, {C. V R}",
year = "2017",
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pages = "105--111",
journal = "European Journal of Trauma and Emergency Surgery",
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T1 - Adenosine diphosphate platelet dysfunction on thromboelastogram is independently associated with increased morality in traumatic brain injury

AU - Daley,M. J.

AU - Enright,Z.

AU - Nguyen,J.

AU - Ali,S.

AU - Clark,A.

AU - Aydelotte,J. D.

AU - Teixeira,P. G.

AU - Coopwood,T. B.

AU - Brown,C. V R

PY - 2017/2/1

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N2 - Purpose: The purpose of this study is to determine if adenosine diphosphate (ADP) platelet dysfunction on thromboelastogram (TEG) is associated with increased in-hospital mortality in patients with head trauma. The hypothesis is that ADP dysfunction is associated with increased mortality. Methods: This retrospective review evaluated trauma patients admitted to a level 1 trauma center from February 2011 to October 2013 who received a TEG. Patients were included if the TEG was drawn within the first 24 h of admission and the head abbreviated injury score was greater than or equal to three. Patients were categorized as severe ADP dysfunction if the degree of ADP inhibition on TEG exceeded 60 %. Results: A total of 90 patients were included (no ADP dysfunction n = 37; ADP dysfunction n = 53). Initial Glasgow Coma Scale [GCS (12 ± 4 vs. 11 ± 5; p = 0.26)] and use of pre-injury antiplatelet agents (30 vs. 28 %; p = 0.88) were similar. Patients with ADP dysfunction on TEG had a higher in-hospital mortality rate (8 vs. 32 %; p < 0.01). ADP dysfunction was independently associated with in-hospital mortality upon fixed logistic regression (OR 6.2; 95 % CI 1.2–33) while controlling for age, gender, hypotension, pre-injury antiplatelet agents, GCS and Injury Severity Score. Conclusion: ADP dysfunction on TEG is associated with increased mortality in patients with traumatic brain injury.

AB - Purpose: The purpose of this study is to determine if adenosine diphosphate (ADP) platelet dysfunction on thromboelastogram (TEG) is associated with increased in-hospital mortality in patients with head trauma. The hypothesis is that ADP dysfunction is associated with increased mortality. Methods: This retrospective review evaluated trauma patients admitted to a level 1 trauma center from February 2011 to October 2013 who received a TEG. Patients were included if the TEG was drawn within the first 24 h of admission and the head abbreviated injury score was greater than or equal to three. Patients were categorized as severe ADP dysfunction if the degree of ADP inhibition on TEG exceeded 60 %. Results: A total of 90 patients were included (no ADP dysfunction n = 37; ADP dysfunction n = 53). Initial Glasgow Coma Scale [GCS (12 ± 4 vs. 11 ± 5; p = 0.26)] and use of pre-injury antiplatelet agents (30 vs. 28 %; p = 0.88) were similar. Patients with ADP dysfunction on TEG had a higher in-hospital mortality rate (8 vs. 32 %; p < 0.01). ADP dysfunction was independently associated with in-hospital mortality upon fixed logistic regression (OR 6.2; 95 % CI 1.2–33) while controlling for age, gender, hypotension, pre-injury antiplatelet agents, GCS and Injury Severity Score. Conclusion: ADP dysfunction on TEG is associated with increased mortality in patients with traumatic brain injury.

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