Altered TEG Parameters Identify Hypercoagulablilty and are of Diagnosis Value for Papillary Thyroid Carcinoma Patients

Lu, Shuanglong; Kang, Rui; Wang, Yongchao; Zhu, Mengjie; Zhao, Lei; Xu, Qinzhu; Song, Ying; Liu, Chen

doi:10.1055/a-0723-3295

Cited by 6 publications

(8 citation statements)

References 28 publications

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“…eu-/hyper-/hypothyroidism, was missing. Thrombocyte count was higher in the papillary cancer group compared with the healthy group (statistically non-signi cant); thrombocyte count was correlated with some of TEG parameters [11]. Similarly, a positive correlation was present between thrombocyte count and ROTEM/TEG parameters in our study indicating thrombotic tendency.…”

Section: Discussionsupporting

confidence: 56%

“…In the literature, there are studies using ROTEM/TEG to detect coagulation and bleeding disorders in trauma, postoperative bleeding, malignancy, ischemic heart disease, liver transplant, cardiac surgeries, and even in ammatory rheumatologic diseases [8][9][10]. The use of ROTEM/TEG to evaluate coagulation disorders in thyroid diseases is not common and has been used only in patients with thyroid cancer [11]. In the study, we aimed to evaluate the hemostatic system globally using ROTEM/TEG, which was never been used before to speci cally investigate thrombotic tendency, and to establish the effects of possible disease-related factors on ROTEM/TEG parameters in thyroid diseases.…”

Section: Introductionmentioning

confidence: 99%

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Does the Tendency to Thrombosis Increase in Autoimmune Thyroid Dysfunction? Rotational Thromboelastometric Analysis

Cansu

Taskiran

Teke

2022

Preprint

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The tendency for thrombosis is a well-known issue in hyperthyroidism, and the tendency for both bleeding and thrombosis has been shown in hypothyroidism. In the study, we aimed to establish the tendency to thrombosis by evaluating the coagulation system in thyroid diseases using thromboelastography (TEG). Thirty patients with new-onset autoimmune-based hypothyroidism, 30 with hyperthyroidism and 30 healthy volunteer subjects were enrolled in this study. Complete blood count, prothrombin time, activated partial thromboplastin time, fibrinogen levels and rotational thromboelastography (ROTEM) were studied. In the ROTEM/TEG analysis, coagulation time (CT), coagulation formation time (CFT) and maximum clot firmness (MCF) were measured. Short CT and/or CFT and/or long MCF were presumed as the tendency to hypercoagulability. The mean age of subjects with hyperthyroidism and hypothyroidism was 46±15.9 years and 44.8±13 years, respectively. The thrombocyte count in the hypothyroid group and both thrombocyte counts and fibrinogen levels in the hyperthyroid group was significantly higher than in the healthy group (p=0.004, p=0.001, p<0.001, respectively). According to ROTEM/TEG results, higher mean MCF figures were noted in both the hypo- and hyperthyroid groups compared with the healthy group (p=0.014 (hypothyroid vs. healthy groups), p=0.020 (hyperthyroid vs. healthy groups)). We showed a tendency for thrombosis using ROTEM in patients with both hyper- and hypothyroidism without thrombosis. The correlation between ROTEM/TEG parameters and the main components of thrombosis formation (thrombocyte count and fibrinogen level) indicate that the main factor might be inflammation (autoimmunity), apart from thyroid hormone levels.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Does the Tendency to Thrombosis Increase in Autoimmune Thyroid Dysfunction? Rotational Thromboelastometric Analysis

Cansu

Taskiran

Teke

2022

Preprint

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“…TPI is a platelet kinetic index, an index used to describe the clot's kinetic potential. 34,35 There was a statistically significant difference in TPI's comparison between the two groups in this study (P = .001). The TPI level was significantly higher than the reference range (6)(7)(8)(9)(10)(11)(12)(13)(14)(15) in both groups.…”

Section: Discussionmentioning

confidence: 53%

Diagnostic Value of Thromboelastography (TEG) for the Diagnosis of Death in Infected Patients

Xuan

Wang

Wei

2021

Clin Appl Thromb Hemost

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In this study, we want to investigate the clinical value of each index of thromboelastography (TEG) on the prognosis of infected patients. The clinical baseline data and TEG test results of 431 infected patients in our hospital’s emergency department between January 2018 and December 2018 were selected. And the patients were divided into death and survival groups to analyze the predictive value of each index of TEG and the joint model on the death of infected patients. In the correlation study of C-reactive protein (CRP) and procalcitonin (PCT) with each TEG parameter, CRP was positively correlated with maximum amplitude (MA, r = 0.145, P = .003) and elasticity constants (E, r = 0.098, P = .043), respectively. PCT was positively correlated with coagulation reaction time (R, r = 0.124, P = .010) and time to MA (TMA) ( r = 0.165, P = .001), respectively; PCT was negatively correlated with α-Angle ( r = 0.124, P = .010) and coagulation index (CI, r = −0.108, P = .026), respectively. Multifactorial regression analysis showed that granulocytes, thrombocytes, platelet distribution width (PDW), and infection site were independent influences on infected patients’ death. Diagnostic data showed that all eight TEG indicators had good specificity for predicting death, but all had poor sensitivity; thrombodynamic potential index (TPI) had the best diagnostic value (area under the curve, AUC = 0.609, P = .002). The eight-indicator modeling of TEG showed that the TEG model combined with PCT and CRP, respectively, had lower diagnostic efficacy than PCT (AUC = 0.756, P < .001); however, TEG had better specificity (82.73%) when diagnosed independently. The granulocytes, thrombocytes, PDW, and infection site are independent influencing factors of death in infected patients. Each index of TEG has better specificity in the diagnosis of death in infected patients.

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“…The otolaryngologist will encounter patients with both hypercoagulable states and hypocoagulable states, from both acquired and congenital coagulopathies. Furthermore, coagulopathic patients are commonplace in the subset of head and neck cancer patients [35][36][37][38]. Strict protocols and guidelines to guide blood component therapy using VETs do not yet exist in otolaryngology.…”

Section: Adoption Of Vets In Otolaryngologymentioning

confidence: 99%

“…Experimental non-randomized study: This study aimed to modify the TEG parameters for papillary thyroid carcinoma and nodular goiters. Using 62 nodular goiter patients, 53 papillary thyroid carcinoma patients, and 61 healthy patients, correlation analysis demonstrated hypercoagulable TEG parameters for papillary thyroid carcinoma patients [38].…”

Section: Lu 2020mentioning

confidence: 99%

Use of Thromboelastography and Rotational Thromboelastometry in Otolaryngology: A Narrative Review

Marsee

Shariff

Wiarda

et al. 2022

JCM

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In the field of otolaryngology—head and neck surgery (ENT), coagulopathies present unique diagnostic and therapeutic challenges. In both hyper- and hypocoagulable patients, management of coagulopathies requires intricate attention to the nature of hemostatic competence. Common coagulation tests (CCTs) offer only a snapshot of hemostatic competence and do not provide a clear insight into the patient’s real-time hemostatic condition. Viscoelastic tests (VETs) offer a holistic and concurrent picture of the coagulation process. Although VETs have found prominent utilization in hepatic transplants, obstetrics, and emergent surgical settings, they have not been fully adopted in the realm of otolaryngology. The objective of this manuscript is to provide an overview of the literature evaluating the current utilization and possible future uses of VETs in the field of otolaryngology. The authors performed a comprehensive literature search of the utilization of VETs in otolaryngology and identified applicable studies that included descriptions of viscoelastic testing. Twenty-five studies were identified in this search, spanning topics from head and neck oncology, microvascular free flap reconstruction, obstructive sleep apnea, adenotonsillectomy, facial trauma, and epistaxis. The applicability of VETs has been demonstrated in head and neck oncology and microvascular free flap management, although their pervasiveness in practice is limited. Underutilization of VETs in the field of otolaryngology may be due to a lack of familiarity of the tests amongst practitioners. Instead, most otolaryngologists continue to rely on CCTs, including PT, PTT, INR, CBC, fibrinogen levels, and thrombin time. Learning to perform, interpret, and skillfully employ VETs in clinical and operative practice can greatly improve the management of coagulopathic patients who are at increased risk of bleeding or thrombosis.

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Altered TEG Parameters Identify Hypercoagulablilty and are of Diagnosis Value for Papillary Thyroid Carcinoma Patients

Cited by 6 publications

References 28 publications

Does the Tendency to Thrombosis Increase in Autoimmune Thyroid Dysfunction? Rotational Thromboelastometric Analysis

Does the Tendency to Thrombosis Increase in Autoimmune Thyroid Dysfunction? Rotational Thromboelastometric Analysis

Diagnostic Value of Thromboelastography (TEG) for the Diagnosis of Death in Infected Patients

Use of Thromboelastography and Rotational Thromboelastometry in Otolaryngology: A Narrative Review

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