Dataset Information

Classification, risk factors, and outcomes of patients with progressive hemorrhagic injury after traumatic brain injury.

ABSTRACT:

Background

According to the pathoanatomic classification system, progressive hemorrhagic injury (PHI) can be categorized into progressive intraparenchymal contusion or hematoma (pIPCH), epidural hematoma (pEDH), subdural hematoma (pSDH), and traumatic subarachnoid hemorrhage (ptSAH). The clinical features of each type differ greatly. The objective of this study was to determine the predictors, clinical management, and outcomes of PHI according to this classification.

Methods

Multivariate logistic regression analysis was used to identify independent risk factors for PHI and each subgroup. Patients with IPCH or EDH were selected for subgroup propensity score matching (PSM) to exclude confounding factors before evaluating the association of hematoma progression with the outcomes by classification.

Results

In the present cohort of 419 patients, 123 (29.4%) demonstrated PHI by serial CT scan. Of them, progressive ICPH (58.5%) was the most common type, followed by pEDH (28.5%), pSDH (9.8%), and ptSAH (3.2%). Old age (≥ 60 years), lower motor Glasgow Coma Scale score, larger primary lesion volume, and higher level of D-dimer were independent risk factors related to PHI. These factors were also independent predictors for pIPCH, but not for pEDH. The time to first CT scan and presence of skull linear fracture were robust risk factors for pEDH. After PSM, the 6-month mortality and unfavorable survival rates were significantly higher in the pIPCH group than the non-pIPCH group (24.2% vs. 1.8% and 12.1% vs. 7.3%, respectively, p < 0.001), but not significantly different between the pEDH group and the non-pEDH group.

Conclusions

Understanding the specific patterns of PHI according to its classification can help early recognition and suggest targeted prevention or treatment strategies to improve patients' neurological outcomes.

SUBMITTER: Wang R

PROVIDER: S-EPMC9926699 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Classification, risk factors, and outcomes of patients with progressive hemorrhagic injury after traumatic brain injury.

Wang Ren R Yang Dian-Xu DX Ding Jun J Guo Yan Y Ding Wan-Hai WH Tian Heng-Li HL Yuan Fang F

BMC neurology 20230213 1

<h4>Background</h4>According to the pathoanatomic classification system, progressive hemorrhagic injury (PHI) can be categorized into progressive intraparenchymal contusion or hematoma (pIPCH), epidural hematoma (pEDH), subdural hematoma (pSDH), and traumatic subarachnoid hemorrhage (ptSAH). The clinical features of each type differ greatly. The objective of this study was to determine the predictors, clinical management, and outcomes of PHI according to this classification.<h4>Methods</h4>Multi ...[more]

PMID: 36782124

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Dataset Information

Classification, risk factors, and outcomes of patients with progressive hemorrhagic injury after traumatic brain injury.

Background

Methods

Results

Conclusions

Publications

Classification, risk factors, and outcomes of patients with progressive hemorrhagic injury after traumatic brain injury.

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