Comparison Between Thromboelastography and Conventional Coagulation Tests in Surgical Patients With Localized Prostate Cancer

Abstract

We aimed to examine hypercoagulable and hypocoagulable conditions in patients with prostate cancer using thromboelastography (TEG) and correlate TEG parameters with conventional coagulation test. The t test was used for comparing TEG parameters and routine coagulation results. Spearman rank-order correlation was used to describe the relationship of TEG and conventional tests. Sensitivity, specificity, positive predictive values, and negative predictive values were determined for bleeding and thrombosis. Totally, 20 patients had active bleeding postoperatively, 16 of whom showed hypocoagulation on TEG test and 9 of whom showed hypocoagulation by routine coagulation test (P ¼ .024). Overall, 60 patients did not have active bleeding postoperatively, 51 of whom showed hypercoagulation detected by TEG test and 42 of whom showed hypercoagulation found by routine coagulation test (P ¼ .040). Remarkably, patients had a little higher fibrinogen (FIB) compared to controls. There was no statistical difference in any of the conventional coagulation indexes between the groups. Correlation analysis showed that reaction time (R) and coagulation time (K) were positively correlated with the prothrombin time-international normalized ratio (PT-INR) and negatively correlated with FIB (P < .001). Contrarily, a-angle and maximum amplitude (MA) were negatively correlated with PT-INR but positively correlated with FIB. Significantly, MA showed the strongest correlation with FIB and R exhibited the strongest correlation with PT-INR. Sensitivity and specificity for bleeding and thrombosis in TEG were higher than those in conventional coagulation test. Accordingly, TEG might be superior in evaluating hypercoagulation and detecting the risk of bleeding in patients with prostate cancer.

Assessment of hypercoagulability using thromboelastography predicts advanced status in renal cell carcinoma

“…Also, our results presented that K time, MA value, and α angle were significantly correlated with FIB. The positive correlation was found between fibrinogen and MA value ( r = .663, P < .05), presenting the similarities with former studies focused on patients with localized prostate cancer . There was also a weak positive correlation between platelet count and MA value, suggesting that the MA value could both reflect the changes in platelet count and the state of platelet quality and function.…”

“…Several studies have proved that the TEG parameters had strong ability in evaluating hypercoagulable status in patients with recurrent and advanced prostate cancer. This test was promising to be a novel tool for risk assessment of VTE in those patients . TEG is able to measure both the quantity and quality of clotting, providing the complete description of coagulation.…”

Comparison of Thromboelastography and Conventional Coagulation Tests in Patients With Severe Liver Disease

“…The median (IQR) length of ICU stay was 16 days ( 3 – 40 ); 12 (86%) of 14 patients who required an ICU admission survived. Median (IQR) length of hospital admission was 22 days (5-91); 29 (85%) patients survived with an overall in-hospital mortality of 15%.…”

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“…e thromboelastogram is a dynamic observation of the blood coagulation process. From the beginning of coagulation, the formation of blood clots to the process of fibrinolysis, a comprehensive assessment of coagulation factors, fibrinogen, and platelet function can be performed [27].…”

“…The thromboelastogram is a dynamic observation of the blood coagulation process. From the beginning of coagulation, the formation of blood clots to the process of fibrinolysis, a comprehensive assessment of coagulation factors, fibrinogen, and platelet function can be performed [ 27 ]. The R value is the time of the coagulation reaction, that is, the time required for the blood clot to start to form from the beginning of the test sample.…”