J Korean Soc Emerg Med.  2021 Dec;32(6):537-547.

Association between disseminated intravascular coagulation scores and mortality in patients with traumatic brain injury

• Park JS
• Min YI
• Lee DH
• Lee BK
• Kim DK
• Cho YS
• Jung YH

Abstract

Objective
Disseminated intravascular coagulation (DIC) is common in patients with traumatic brain injury (TBI) and is associated with the prognosis of TBI. We aimed to analyze and compare the performances of the International Society on Thrombosis and Hemostasis (ISTH), the Korean Society on Thrombosis and Hemostasis (KSTH) and the Japanese Association for Acute Medicine (JAAM) scoring systems in predicting in-hospital mortality.
Methods
In this retrospective observational study, severe trauma patients with TBI who visited our emergency department between January 2018 and December 2020 were included. Receiver operating characteristic analysis was performed to examine the prognostic performance of the three different DIC scoring systems. The primary outcome was inhospital mortality.
Results
A total of 851 patients were included, and the in-hospital mortality rate was 17.7% (n=151). According to the multivariate analysis results, the ISTH (odds ratio [OR], 1.784; 95% confidence interval [CI], 1.320-2.412), KSTH (OR, 2.735; 95% CI, 2.022-3.698) and JAAM (OR, 1.751; 95% CI, 1.473-2.083) scores were associated with in-hospital mortality. The areas under the curves (AUCs) of ISTH, KSTH and JAAM scores for predicting in-hospital mortality were 0.686 (95% CI, 0.654-0.717), 0.708 (95% CI, 0.676-0.738) and 0.762 (95% CI, 0.731-0.790), respectively. The AUC of the JAAM score was significantly different from that of the ISTH and KSTH scores.
Conclusion
Three different DIC scores were associated with in-hospital mortality in TBI patients. Among the DIC scores, the JAAM score can be a useful tool for predicting in-hospital mortality in TBI patients.

Keyword

Traumatic brain injury; Prognosis; Mortality; Disseminated intravascular coagulation