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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0044-1780494
Original Article

Predicting Progressive Hemorrhagic Injury Following Traumatic Brain Injury by the Evaluation of D-Dimer/Fibrinogen Ratio

Akshay Patidar 
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Anurag Chaudhary
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Vinod Sharma
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
,
Ashok Gupta
1   Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
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Abstract

Background Prognosis of traumatic brain injury (TBI) significantly depends on the incidence of progressive hemorrhagic injury (PHI). The present study was conducted to assess whether D-dimer/fibrinogen ratio can predict PHI among the patients with TBI.

Materials and Methods A total of 150 patients were included in this retrospective study; among them 72 had PHI and 78 did not have PHI. Demographic, clinical, radiological, and laboratory parameters including plasma D-dimer and plasma fibrinogen levels and subsequently D-dimer/fibrinogen ratio were evaluated. Independent t-test, Mann–Whitney U test, chi-square test, Fisher's exact test, and multivariate logistic regression were used for statistical analysis.

Results Age, injury time, first computed tomography time, Glasgow Coma Scale scores, unreactive pupils, abnormal cisterns, midline shift above 5 mm, skull base fracture, epidural hematoma, subdural hematoma, intraventricular hemorrhage, cerebral hematoma, brain contusion, plasma D-dimer concentration, plasma fibrinogen concentration, and D-dimer/fibrinogen ratio vary significantly between PHI and non-PHI groups (p < 0.05). Multivariate logistic regression showed that the Glasgow Coma Scale score (odds ratio [OR], 0.531; 95% confidence interval [CI], 0.436–0.648; p = 0.004) and D-dimer/fibrinogen ratio (OR, 3.784; 95% CI, 2.086–6.867; p = 0.027) were the two independent predictors for PHI.

Conclusion D-dimer/fibrinogen ratio is a useful parameter in predicting the incidence of PHI among the patients with TBI.

Keywords

D-dimer/fibrinogen ratio - Glasgow Coma Scale - plasma fibrinogen - traumatic brain injury - progressive hemorrhagic injury


Publication History

Article published online:
03 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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