Articles: traumatic-brain-injuries.
-
Multicenter Study Observational Study
Tranexamic Acid in Pediatric Traumatic Brain Injury: A Multicenter Retrospective Observational Study.
Tranexamic acid (TXA) can be used after trauma to prevent bleeding. Our goal was to examine the influence of TXA on morbidity and mortality for children with severe traumatic brain injury (TBI). ⋯ TXA administration was not associated with either death or poor neurologic outcome. Prospective clinical trials of TXA usage in children with severe TBI are needed.
-
Review
Management of post-injury anticoagulation in the traumatic brain injury patient: A scoping review.
Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality among trauma patients. The care of these patients continues to be a complex endeavor with prevention of associated complications, often requiring as much attention as that of the treatment of the primary injury. Paramount among these are venous thromboembolic events (VTE) due to their high incidence, additive effect on the risk of morbidity and mortality, and the careful balance that must be utilized in their diagnosis and treatment to prevent progression of the brain injury itself. ⋯ The timing of prophylaxis remains important, as the risk of VTE increases with each day that prophylaxis is held. Consensus findings favor initiation within 24-72 h, in the absence of documented progression, life threatening bleeding, or need for major surgical intervention. Despite available data, there continues to be significant variability in practice patterns which we hope to address with this review.
-
Emerg Med Australas · Feb 2025
Observational StudyEvaluation of older patients with minor blunt head trauma to identify those who do not have clinically important traumatic brain injury and can be safely managed without cranial computed tomography.
Our primary aim was to identify a low-risk subgroup of older adults (aged 65 and older) presenting to ED with minor head trauma which can be safely managed without a cranial CT (cCT). ⋯ Alert, haemodynamically stable, older ED adults with suspected head trauma had a low incidence of ciTBI in the present study. Abnormal physical examination findings were consistently present in patients with ciTBI. Shared decision-making prior to cCT may be the pragmatic way ahead in the management of this patient cohort, especially among those from RACFs.
-
Journal of neurosurgery · Feb 2025
Novel application of latent class analysis to outcome assessment in traumatic brain injury with multiple injury subtypes or poly-TBI.
The aim of this study was to stratify poly-traumatic brain injury (poly-TBI) patterns into discrete classes and to determine the association of these classes with mortality and withdrawal of life-sustaining treatment (WLST). ⋯ Distinct poly-TBI classes were associated with increased in-hospital mortality and WLST. Further research with larger datasets will allow for more comprehensive poly-TBI class definitions and outcomes analysis.
-
Prior research suggests that plasma may improve outcomes in traumatic brain injury (TBI). We examined the association between plasma administration and mortality in moderate-severe TBI in a large retrospective cohort, hypothesizing plasma is associated with decreased mortality after accounting for confounding covariates. ⋯ Administration of plasma within the first four hours after hospital presentation was not associated with decreased or increased mortality in adult patients with moderate to severe TBI after confounder adjustment. Interaction analysis suggests the presence of hemorrhage improves the effect of plasma on mortality in TBI. This important clinical question should be answered with a prospective randomized study of plasma for nonbleeding patients with TBI.