Abstract: Objective  To investigate the effects of early fresh frozen plasma transfusion before opening endocranium on incidence of delayed traumatic intracranial hematoma(DTIH) in patients with subdural hematoma after trauma brain injury. 
Methods  According to occurrence of DTIH after surgery, 197 of patients with severe trauma brain injury(TBI) were divided into DTIH group or non-DTIH(NDTIH) group. The patients′ demographics(gender, age, body mass index), vital signs(pre-operative mean arterial pressure, heart rate), initial injury severity(ISS), peri-operative transfusion(type, volume), blood product(type, volume), transfusion time of fresh frozen plasma, laboratory tests, DTIH and mortality within 30 days post-TBI were collected. To account risk factors of DTIH, the significant statistic factors between two groups in the univariate analysis were involved in a bivariate logistic regression. 
Results  There were 32 patients developing new DTIH after surgery. The incidence of new DTIH after surgery was 16.2%. Compared with NDTIH group, the patients in DTIH group showed lower GCS, more hematoma volume, and higher ratio of early fresh frozen plasma transfusion(P＜0.05). In a bivariate logistic regression model, GCS(OR=4.23, 95%CI=1.62-8.72, P＜0.001), hematoma volume ≥100 mL(OR=5.39, 95%CI=1.75-9.38, P＜0.001), and early fresh frozen plasma transfusion(OR=1.54, 95%CI=1.27-4.29, P=0.016) were correlated with new DITH after surgery. 
Conclusion  Increased incidence of DTIH in patients with subdural hematoma after traumatic brain injury might be associated with early fresh frozen plasma transfusion.

Key words: craniocerebral trauma, intracranial hemorrhages, Glasgow coma scale