The Incidence and Risk Factors for Hypofibrinogenemia in Patients with Traumatic Brain Injury Undergoing Surgery

Fibrinogen is the primary substrate of coagulation. Fibrinogen depletion occurs in acute traumatic coagulopathy and is associated with unfavorable outcomes. Fibrinogen levels also decrease following traumatic brain injury (TBI) due to hypothermia, acidosis, and hypoperfusion leading to hyperfibrinolysis. This study was conducted to identify risk factors and the incidence of hypofibrinogenemia following TBI and also its effect on perioperative complications and postoperative outcome. A total of 51 adult patients with TBI were included in the study, and 33.3% of them had hypofibrinogenemia. Patients with low fibrinogen levels had lower preoperative Glasgow Coma Score (GCS), had associated derangement of international normalized ratio (INR), received more blood transfusions, and had lower discharge GCS compared with those with normal fibrinogen levels. Patients with hypofibrinogenemia had higher incidence of repeat surgery. In conclusion, hypofibrinogenemia occurs commonly after TBI and is associated with poor outcomes.