Thrombocytopenia and Coagulopathy in Indian Patients With Isolated Head Trauma

  • Ruchika Sodhi University College of Medical Science &GTB hospital, Delhi
  • Meera Sikka University College of Medical Science &GTB hospital, Delhi
  • Mrinalini Kotru University College of Medical Science &GTB hospital, Delhi
  • Gurubachan Singh University College of Medical Science &GTB hospital, Delhi
Keywords: Coagulopathy, head trauma, prothrombin time, activated partial thromboplastin time, thrombocytopenia

Abstract

Background: Patients with head injury, a leading cause of morbidity and mortality worldwide are susceptible to the early development of coagulopathy. As its presence further contributes to an adverse outcome, early identification assumes importance. This study aimed to assess the  prevalence  and  nature  of  hemostatic  abnormalities  in  Indian patients  with  isolated head trauma and  correlate them with outcome.Methods: Complete blood counts with platelet count and screening tests of hemostasis PT, APTT, TT were performed on 100 patients with isolated head trauma admitted within 12hrs of injury. The severity of injury was assessed by Glasgow coma score (GCS).Result: Based on the GCS, head injury was classified as mild (GCS 13-15, n=45), moderate (GCS 9-12, n=28) and severe (GCS 3-8, n=27). Thrombocytopenia was present in 48% patients. Coagulopathy [prolonged PT (>14 sec) and/or APTT (>34 sec)] was present in 39% patients. Twenty-six patients died. Mortality was significantly (p<0.001) higher in patients with coagulopathy and/or thrombocytopenia. Platelet count was significantly lower and PT, APTT, TT significantly (p<0.001) higher in non survivors as compared to survivors. Platelet count significantly (p<0.05) decreased while PT, APTT and TT increased with increasing severity of injury. Seven (17.9%) patients with mild injury also had coagulopathy.Conclusion: Coagulopathy and thrombocytopenia were associated with a significantly higher mortality and was present even in patients with mild head injury. Measurement of hemostatic parameters in these patients   irrespective of severity of injury will help in identification of patients at poor risk thus aiding better management and improved survival. DOI: 10.21276/APALM.1617

Author Biographies

Ruchika Sodhi, University College of Medical Science &GTB hospital, Delhi
MD Pathology
Meera Sikka, University College of Medical Science &GTB hospital, Delhi
MD Pathology, Professor& Head of Department
Mrinalini Kotru, University College of Medical Science &GTB hospital, Delhi
DM Hematopathology
Gurubachan Singh, University College of Medical Science &GTB hospital, Delhi
Mch Neurosurgery, Professor and Head of Department

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Published
2018-01-27
Issue
Vol 5 No 1 (2018)
Section
Original Article

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