创伤性脑损伤患者的血清纤维蛋白原水平及纤维蛋白原给药：一项系统评价和Meta分析方案
Serum fibrinogen level and fibrinogen administration in patients with traumatic brain injury: A systematic review and meta-analysis protocol.
作者信息
Igoli Joanne, Daniel Jeremiah Oluwatomi Itodo, Oludele Halleluyah, Alao Adedoyin Esther, Ogedegbe Idemudia Stephen, Olaniyan Adewale, Adebayo Michael Adeshola, Matthew Damilola, Oyepitan Temidayo Elizabeth, Brabi Daniel, Olukoya Olatomiwa, Osunronbi Temidayo
机构信息
Deanery of Clinical Sciences, The University of Edinburgh, Edinburgh, United Kingdom.
Neurosurgery Department, Surgery Interest Group of Africa, Lagos, Nigeria.
出版信息
PLoS One. 2025 Jul 30;20(7):e0310066. doi: 10.1371/journal.pone.0310066. eCollection 2025.
INTRODUCTION
Traumatic Brain Injury (TBI) is a leading cause of disability and death globally. It has a significant economic burden. Coagulopathy has been identified as one of the key factors contributing to the poor outcomes observed in TBI patients, and it has been theorised that the management of coagulopathy will improve patient outcomes. Low serum fibrinogen levels denote a coagulopathic state, and the therapeutic administration of fibrinogen has been proposed to correct this state. However, there is no consensus on its efficacy in patients with TBI. Hence, this systematic review and meta-analysis seeks to ascertain the prognostic value of serum fibrinogen levels in patients with TBI and assess the effect of fibrinogen administration on these patients.
METHODS
Using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, we will perform a comprehensive search of Scopus, Medline, Embase and Cochrane Library to retrieve all original articles that investigate the prognostic value of fibrinogen levels and/or the effect of fibrinogen administration in TBI patients. Primary outcomes include functional outcome and mortality assessments such as the Glasgow Outcome Score and modified Rankin Score. Secondary outcomes include progressive intracranial haemorrhage/contusion and need for surgical intervention. Data collected will encompass participant demographics, measured fibrinogen levels, dose of fibrinogen administered and specified outcome measures.
CONCLUSION
Findings from this study, specifically the evidence if fibrinogen level has prognostic value and if fibrinogen administration improves patient outcomes, will help inform future TBI management. It will also enhance shared decision-making between healthcare professionals and patients if fibrinogen has a prognostic value, as this value could be used to communicate more effectively the expected prognosis post-TBI. Thus, TBI patient outcomes can be optimised accordingly.
PROSPERO REGISTRATION NUMBER
CRD42024556497. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024556497.
引言
创伤性脑损伤（TBI）是全球致残和致死的主要原因之一。它带来了巨大的经济负担。凝血功能障碍已被确定为导致TBI患者预后不良的关键因素之一，并且有理论认为，对凝血功能障碍的管理将改善患者的预后。血清纤维蛋白原水平低表示处于凝血功能障碍状态，有人提出通过纤维蛋白原的治疗性给药来纠正这种状态。然而，对于其在TBI患者中的疗效尚无共识。因此，本系统评价和荟萃分析旨在确定血清纤维蛋白原水平对TBI患者的预后价值，并评估纤维蛋白原给药对这些患者的影响。
方法
我们将使用系统评价和荟萃分析方案的首选报告项目（PRISMA-P）指南，全面检索Scopus、Medline、Embase和Cochrane图书馆，以检索所有研究纤维蛋白原水平的预后价值和/或纤维蛋白原给药对TBI患者影响的原始文章。主要结局包括功能结局和死亡率评估，如格拉斯哥结局评分和改良Rankin评分。次要结局包括进行性颅内出血/挫伤以及手术干预的需求。收集的数据将包括参与者的人口统计学信息、测得的纤维蛋白原水平、给予的纤维蛋白原剂量以及特定的结局指标。
结论
本研究的结果，特别是关于纤维蛋白原水平是否具有预后价值以及纤维蛋白原给药是否能改善患者预后的证据，将有助于为未来的TBI管理提供信息。如果纤维蛋白原具有预后价值，它还将加强医疗保健专业人员与患者之间的共同决策，因为这个价值可用于更有效地传达TBI后的预期预后。因此，可以相应地优化TBI患者的预后。
PROSPERO注册号：CRD42024556497。可从以下网址获取：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024556497 。
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