Abstract: Objective To analyze the association of the maximal amplitude (MA) of thromboelastography (TEG) and clot index (CI) with delayed traumatic intracranial hematoma (DTICH) in patients with craniocerebral trauma.Methods One hundred and fifty patients with craniocerebral trauma in the hospital were collected between 2014 to 2018. The Patients were divided into DTICH group (n=36) and non-DTICH group (n=114) by presence or absence of delayed traumatic intracranial hematoma. General clinical data, MA of TEG and CI in the two groups were collected and analyzed for their relations with DTICH.Results The rates of pupillary changes, Babinski sign, skull fracture, cerebral palsy, basal cistern compression and the level of diastolic blood pressure in the DTICH group were significantly higher than those in the non-DTICH group (both P<0.05). The rates of MA greater than 70 mm, CI greater than or equal to 3 and △MA_5-1, △MA_10-1, △MA_15-1, △CI_5-1, △CI_10-1, △CI_15-1 on days 5, 10 and 15 after trauma in the DTICH group were remarkably elevated compared to those in the non-DTICH group (P<0.05). Multivariate logistic regression analysis showed that combined Babinski sign, skull fracture and △MA_5-1at admission were risk factors for DTICH in patients with craniocerebral trauma while the timing of surgery was a protective factor.The area under the ROC curve with △MA_5-1 predicting DTICH was 0.640, the optimal sensitivity threshold was 3.047, with the sensitivity of 71.40% and the specificity of 60.41%. Taking△MA_5-1 over 3.047 as the grouping cut-off value, we found a lower cumulative survival rate on day 15 than that of △MA_5-1 below 3.047 group (χ²=5.143, P=0.023).Conclusions The △MA_5-1, combined Babinski sign at admission and skull fracture are risk factors for DTICH in patients with craniocerebral trauma. Clinical coagulation monitoring is needed. The △MA_5-1 more than 3.047 would indicate a high risk of DTICH and poor prognosis.

Key words: Thromboelastography, Craniocerebral trauma, Delayed traumatic intracranial hematoma