From the Bloodworks Research Institute (J.-f.D.); Division of Hematology, Department of Medicine (J-f.D.), and Department of Neurological Surgery (F.Z.), University of Washington School of Medicine, Seattle, Washington; Tianjin Institute of Neurology (J.Z.); and Department of Neurosurgery (J.Z.), Tianjin Medical University General Hospital, Tianjin, China.
J Trauma Acute Care Surg. 2023 Jan 1;94(1S Suppl 1):S50-S55. doi: 10.1097/TA.0000000000003748. Epub 2022 Jul 15.
Coagulopathy after traumatic brain injury (TBI) is common and has been closely associated with poor clinical outcomes for the affected patients. Traumatic brain injury-induced coagulopathy (TBI-IC) is consumptive in nature and evolves rapidly from an injury-induced hypercoagulable state. Traumatic brain injury-induced coagulopathy defined by laboratory tests is significantly more frequent than clinical coagulopathy, which often manifests as secondary, recurrent, or delayed intracranial or intracerebral hemorrhage. This disparity between laboratory and clinical coagulopathies has hindered progress in understanding the pathogenesis of TBI-IC and developing more accurate and predictive tests for this severe TBI complication. In this review, we discuss laboratory tests used in clinical and research studies to define TBI-IC, with specific emphasis on what the tests detect and what they do not. We also offer perspective on developing more accurate and predictive tests for this severe TBI complication.
颅脑创伤（TBI）后发生的凝血功能障碍很常见，并且与受影响患者的临床预后不良密切相关。创伤性脑损伤诱导的凝血功能障碍（TBI-IC）本质上是消耗性的，并且会迅速从损伤诱导的高凝状态演变而来。实验室检查定义的创伤性脑损伤诱导的凝血功能障碍比临床凝血功能障碍更为常见，后者常表现为继发性、复发性或迟发性颅内或脑实质内出血。实验室和临床凝血功能障碍之间的这种差异阻碍了对 TBI-IC 发病机制的理解和开发更准确、更具预测性的这种严重 TBI 并发症的检测方法。在这篇综述中，我们讨论了用于临床和研究研究中定义 TBI-IC 的实验室检测方法，特别强调了这些检测方法检测到的内容以及未检测到的内容。我们还对开发这种严重 TBI 并发症的更准确、更具预测性的检测方法提供了一些看法。
