P42 – Does Platelet Transfusion Improve In-Hospital Neurological Outcome in Patients with Traumatic Intracranial Hemorrhage

Author(s):
Zain Nasim, Nasim Ahmed, Johnson Victor, Yen-Hong Kuo, John Davis, Toms River High School North

Background: The purpose of the study was to see the neurological improvement in patients with traumatic brain injury (TBI) who received platelet transfusion.

Hypothesis: Platelet transfusion does not help in-hospital neurological outcome in TBI.

Methods: A total of 516 consecutive patients were studied for last two years. The subjects’ were selected based on all adult patients that sustained TBI and computerized tomography (CT) scan showed of an intracranial hemorrhage. The patients were divided into a group (1), those who received platelet transfusions within 24 hours and a group (2) those who did not receive platelets. Patient demographic characteristics and the neurological outcome, analyzed by the Glasgow Coma scale (GCS) at the time of admission and discharge, were assessed. Statistical analysis was performed using Pearson Chi-squared test, Fisher’s exact test and Wilcoxon rank sum test.

Results: Ninety two out of 516 patients (18%) received platelet transfusion. There was no significant differences between the groups in terms of male gender ((P=0.25). However, there were significant differences regarding of age (P<0.001), and the Injury Severity Score (ISS) (P=0.001). Results showed that Median GCS scores at admission between the groups were significantly different (P=0.008). However, the discharge GCS scores were not significantly different ( P=0.11). There was no improvement regarding the initial and discharged GCS score between the groups ( P=0.45). The mortality was higher in Group 1 (21.7%) that of Group 2 (8.7%) (P<0.001). The disposition to home was significantly higher in Group 2 (P<0.001) whereas disposition to rehabilitation was higher in Group 1 (P<0.001). Multivariate analysis showed higher mortality in group 1 was significantly associated with higher ISS (P<0.001).

Conclusions: Platelet transfusion within 24 hours of admission following TBI shows no positive GCS improvement compared with no platelet transfusion. Mortality in Platelet transfusion Group was significantly higher and was associated with higher ISS in the platelet transfusion group.