Limited data exist regarding the use of
hemostatic adjuncts on the progression of
traumatic intracranial hemorrhage (tICH). The objective of this study was to examine the impact of
platelet transfusion and
desmopressin (
DDAVP) administration on
hemorrhage progression following tICH. We hypothesized that platelet and
DDAVP administration would not result in decreased early hemorrhagic progression. We performed a three-year retrospective analysis of a Level 1 trauma center database to identify all adult patents with blunt tICH. The primary outcome was early (≤4 hours) radiographic hemorrhagic progression. Secondary outcomes included mortality, frequency of operative interventions, and complications. Multiple logistic regression analysis was performed to identify predictors for
hemorrhage progression and mortality. A propensity score analysis also was performed to minimize differences and improve comparability between patients who received platelets and
DDAVP and those who did not. Of 408 patients with tICH meeting the inclusion criteria, 126 received platelets and
DDAVP (P/D [+]) and 282 did not (P/D [-]). Overall, 37% of patients demonstrated early radiographic
hemorrhage progression. On univariate analysis, there was no difference in the incidence of
hemorrhage progression between groups (43.7% [P/D (+)] vs. 34.2% [P/D (-)]; p = 0.07). On multivariate analyses, platelet and
DDAVP administration was not associated with either a decreased risk of
hemorrhage progression (odds ratio [OR] = 1.40, confidence interval [CI] = 0.80-2.40; p = 0.2) or mortality (OR = 1.50, CI = 0.60-4.30; p = 0.4). The administration of platelets and
DDAVP is not associated with a decreased risk for early radiographic
hemorrhage progression in patients with tICH. Further prospective study of these potentially
hemostatic adjuncts in patients with tICH is potentially warranted.