Introduction: Platelet transfusion is currently of unclear efficacy as a therapy for traumatic intracranial hemorrhage. Establishing the strength of platelet transfusion as a predictive factor in determining patient outcomes would elucidate its value as a treatment choice, helping to reduce morbidity and mortality.
Methods: A 2003-2013 consecutive case series of 2198 patients with intracranial hemorrhage from our institution’s trauma registry were identified. Patient disposition, categorized into “home,” “rehab/skilled nursing,” and “hospice/death,” was used as a dependent variable in a logistic regression to evaluate the role of platelet transfusion. Independent variables that were controlled for included sex, age, systolic blood pressure, craniectomy, externalized ventricular drain placement, international normalized ratio, blood alcohol level, anticoagulation status, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and anti-platelet therapy status. All possible logistic regressions were run and assigned Akaike Information Criterion scores. The logistic regression with lowest corrected Akaike Information Criterion score was selected.
Results: The resultant logistic regression with the lowest Akaike Information Criterion score excluded platelet transfusion as a predictive element in determining patient outcomes.
Conclusions: This study provides evidence that therapeutic platelet administration may not benefit patients with traumatic intracranial hemorrhage. Further prospective work is needed to substantiate this association.
Patient Care: Our research will improve patient care by giving clinicians evidence based data on the efficacy of platelet transfusions in treating traumatic intracranial hemorrhage. This will help physicians provide the best care possible with the best chance of improving patient outcomes.
Learning Objectives: By the conclusion of this session, participants should be able to 1) Describe the important of platelet transfusion as a therapy for traumatic intracranial hemorrhage. 2) Discuss, in small groups the efficacy of platelet transfusion and other possible therapies for traumatic intracranial hemorrhage. 3) Identify an effective treatment for traumatic intracranial hemorrhage.