Impact of fibrinogen level on the prognosis of patients with traumatic brain injury: a single-center analysis of 2570 patients.
Impact of fibrinogen level on the prognosis of patients with traumatic brain injury: a single-center analysis of 2570 patients.
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纤维蛋白原水平对脑外伤患者预后的影响：2570例患者的单中心分析
DOI：
10.1186/s13017-020-00332-1
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发表时间：
2020-09-25
期刊：
影响因子：
--
通讯作者：
Hu J
中科院分区：
文献类型：
--
作者：
Lv K;Yuan Q;Fu P;Wu G;Wu X;Du Z;Yu J;Li Z;Hu J
纤维蛋白原可能在创伤患者的生存中发挥重要作用；然而，其在创伤性脑损伤（TBI）中的作用及其与疾病预后的相关性仍知之甚少。本研究的目的是确定 TBI 患者中 TBI 相关低纤维蛋白原血症的发生率，并评估纤维蛋白原水平对死亡率和临床结果的预后价值。总共对 2570 名连续 TBI 患者进行了回顾性研究。损伤后 3 个月使用格拉斯哥结果评分 (GOS) 评估确定预后评估。使用三次样条函数检查纤维蛋白原水平与死亡率或结果之间关系的形状。进行逻辑回归分析以确定纤维蛋白原水平与 3 个月功能结果之间的关联。 992 名 (38.6%) 患者入院时观察到纤维蛋白原浓度< 2 g/L。多变量分析显示，对于纤维蛋白原水平 < 2.0 g/L 的患者，这些水平是 3 个月死亡率的独立预后因素（比值比 [OR]，0.91；95% 置信区间 [CI]，0.89–0.93；P < .001）。相比之下，对于纤维蛋白原水平< 2.5 g/L的患者，该水平是3个月时良好结局的独立预后因素（OR，1.654；95% CI，1.186-2.306；P = .003）。对于纤维蛋白原水平 > 3.0 g/L 的患者也观察到类似的结果，该水平是 3 个月时良好结局的独立预后因素（OR，0.771；95% CI，0.607-0.979；P = 0.033）。纤维蛋白原是 TBI 患者临床结果的独立预后因素。将纤维蛋白原水平维持在 2.5 至 3 g/L 之间可能会改善 TBI 患者的临床结果。
Fibrinogen may play an important role in the survival of trauma patients; however, its role in traumatic brain injury (TBI) and its correlation with disease prognosis remain poorly understood. The aims of this study were to determine the incidence of TBI-associated hypofibrinogenemia in patients with TBI and to evaluate the prognostic value of fibrinogen level with respect to mortality and clinical outcomes. A total of 2570 consecutive TBI patients were retrospectively studied. Prognostic evaluations were determined using the Glasgow Outcome Score (GOS) assessment 3 months after injury. The shape of the relationship between fibrinogen level and mortality or outcome was examined using cubic spline functions. Logistic regression analyses were conducted to identify the association between fibrinogen level and 3-month functional outcomes. Fibrinogen concentrations < 2 g/L were observed in 992 (38.6%) patients at the time of admission. Multivariate analyses showed that for patients with fibrinogen levels < 2.0 g/L, those levels were an independent prognostic factor for 3-month mortality (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.89–0.93; P < .001). By contrast, for patients with fibrinogen levels < 2.5 g/L, the levels were an independent prognostic factor for favorable outcomes at 3 months (OR, 1.654; 95% CI, 1.186–2.306; P = .003). Similar results were also seen for patients with fibrinogen levels > 3.0 g/L, with the levels being an independent prognostic factor for favorable outcomes at 3 months (OR, 0.771; 95% CI, 0.607–0.979; P = .033). Fibrinogen is an independent prognostic factor for clinical outcomes in TBI patients. Maintaining the level of fibrinogen between 2.5 and 3 g/L may improve clinical outcomes in patients with TBI.
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DOI：
10.1097/ta.0b013e318169cd3c
发表时间：
2008-05-01
影响因子：
--
作者：
Brohi, Karim;Cohen, Mitchell J.;Pittet, Jean-Francois
通讯作者：
Pittet, Jean-Francois
影响因子：
16.6
作者：
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影响因子：
16.2
作者：
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通讯作者：
Akassoglou, Katerina
DOI：
10.1152/ajpendo.00137.2005
发表时间：
2005-11-01
影响因子：
5.1
作者：
Martini, WJZ;Chinkes, DL;Wolfe, RR
通讯作者：
Wolfe, RR
影响因子：
4.8
作者：
Carney, Nancy;Totten, Annette M.;Ghajar, Jamshid
通讯作者：
Ghajar, Jamshid