Association of the bleeding time test with aspects of traumatic brain injury in patients with alcohol use disorder

• Published in: Acta neurochirurgica 2020-07, Vol.162 (7), p.1597-1606
• Main Authors: Tsitsopoulos, P. P., Marklund, N., Rostami, E., Enblad, P., Hillered, L.
• Format: Article
• Language: English
• Subjects: Adult; Alcohol use; Alcohol use disorder; Alcoholism - blood; Alcoholism - complications; Bleeding; Bleeding Time; Blood Coagulation; Brain Injuries, Traumatic - blood; Brain Injuries, Traumatic - complications; Brain trauma; Clinical Medicine; Female; Health risk assessment; Hematoma; Hemostasis; Humans; Injury severity; Interventional Radiology; IVY bleeding time test; Kirurgi; Klinisk medicin; Male; Mechanical ventilation; Medical and Health Sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Nausea; Neurology; Neuroradiology; Neurosurgery; Original - Brain Trauma; Original Article - Brain Trauma; Outcome; Platelets; Surgery; Surgical Orthopedics; Traumatic brain injury
• ISSN: 0001-6268; 0942-0940; 0942-0940
• DOI: 10.1007/s00701-020-04373-y

Background—aim Traumatic brain injury (TBI) and alcohol use disorder (AUD) can occur concomitantly and be associated with coagulopathy that influences TBI outcome. The use of bleeding time tests in TBI management is controversial. We hypothesized that in TBI patients with AUD, a prolonged bleeding time is associated with more severe injury and poor outcome. Material and methods Moderate and severe TBI patients with evidence of AUD were examined with bleeding time according to IVY bleeding time on admission during neurointensive care. Baseline clinical and radiological characteristics were recorded. A standardized IVY bleeding time test was determined by staff trained in the procedure. Bleeding time test results were divided into normal (≤ 600 s), prolonged (> 600 s), and markedly prolonged (≥ 900 s). Normal platelet count (PLT) was defined as > 150,000/μL. This cohort was compared with another group of TBI patients without evidence of AUD. Results Fifty-two patients with TBI and AUD were identified, and 121 TBI patients without any history of AUD were used as controls. PLT was low in 44.2% and bleeding time was prolonged in 69.2% of patients. Bleeding time values negatively correlated with PLT ( p