THE ROLE OF FIBRIN DEGRADATION PRODUCT AND D-DIMER FOR ESTIMATING PROGNOSIS ACCORDING TO SEVERITY OF TRAUMA AND INTRACRANIAL LESION TYPES IN HEAD INJURY

In this prospective study fibrin degradation product (FDP) and D-Dimer has been used for estimating outcome according to several parameters in head injury. Thirty-one mild head injuries, 24 moderate head injuries and 23 severe head injury cases have been studied. FDP was found 32.2% higher and D-Dimer was found 61.3% higher in mild head injury group. In moderate head injury group FDP showed 41.7% and D-Dimer 75% higher results. These results were 86.2% higher for FDP and 100% for D-Dimer in severe head injury group. According to intracranial lesion types, in the lesions which are with parenchimal injury (depressed fractures, intracerebral hematoma, gun shot wounds) FDP was 75-100% and D-Dimer was 100% higher than normal. In lesions causing parenchimal compression (epidural hematoma, acut subdural hematoma, subarachnoid hemorrhages) FDP was 40-63.4%, D-Dimer was 66-100% higher than normal. In the survived cases FDP was 40% and D-Dimer was 71.6% higher than normal. In mortal cases FDP was 88.8% and D-Dimer was 96.4% higher than normal. This study demonstrated that FDP and D-Dimer concentration levels are correlated with the severity of trauma, the type of intracranial lesion, and estimation of prognosis.

KAFA TRAVMALARINDA TRAVMA ÞÝDDET GRUPLARI VE ÝNTRAKRANÝYAL LEZYON TÝPLERÝNE GÖRE SONUÇLARI TAHMÝN ETMEDE FÝBRÝN YIKIM ÜRÜNLERÝ VE D-DÝMER'ÝN ROLÜ

Bu prospektif çalýþma kafa travmalarýnda çeþitli parametrelere göre sonuçlarý tahmin etmek için koagülasyon testlerinden fibrin yýkým ürünleri (FYÜ) ve D-Dimer kullanýlarak yapýlmýþtýr. Çalýþmaya hafif travmalý 31, orta þiddette travmalý 24, þiddetli travmalý 23 hasta alýnmýþtýr. Hafif travma grubunda; FYÜ %32.2, D-Dimer %61.3, orta þiddetli travma grubunda FYÜ %41.7, D-Dimer %75, þiddetli travmalarda FYÜ %86.2, D-Dimer %100 oranýnda yüksek olarak bulunmuþtur. Ýntrakraniyal lezyon tiplerine göre; beyin parenkiminde hasar yapan lezyonlarda (çökme kýrýklarý, intraserebral hematom, ateþli silah yaralanmalarý), FYÜ %75-100, D-Dimer %100, beyinde kompresyon etkisi oluþturan lezyonlarda (epidural hematom, akut subdural hematom, subaraknoid kanama) ise FYÜ %40-63.4, D-Dimer %66-100 arasýnda, bilgisayarlý tomografisi normal olan hastalarda FYÜ %25, D-Dimer %50 oranýnda yüksek olarak bulunmuþtur. Yaþayan hastalarda FYÜ %40, D-Dimer %71.6, ölen hastalarda FYÜ %88.8, D-Dimer %96.4 oranýnda yüksek konsantrasyonda saptanmýþtýr. Bu çalýþmada; FYÜ'leri ve D-Dimer konsantrasyon düzeyleri, travma þiddeti, intrakraniyal lezyon cinsi ve prognozu tahmin etme açýsýndan iliþkili bulunmuþtur.