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

Xuan, Jingchao; Wang, Junyu; Wei, Bing

doi:10.1177/10760296211047231

Cited by 4 publications

(4 citation statements)

References 38 publications

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“…TEG parameters can vary based on the sampling time. 21 22 Thus, analysis of follow-up TEG data could have strengthened our results. Finally, this was a single-center study.…”

Section: Discussionsupporting

confidence: 59%

Hypercoagulability on Thromboelastography Can Predict the Functional Outcomes in Patients with Acute Ischemic Stroke

Ryu

Bae

et al. 2023

Thromb Haemost

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Background: Thromboelastography (TEG) is a useful test that evaluates the coagulation and fibrinolysis pathways. We investigated the association between the Reaction time (R), a TEG parameter for hypercoagulability, and functional outcome based on the occurrence of hemorrhagic transformation (HT) and early neurological deterioration (END). Methods: We enrolled ischemic stroke patients and performed TEG immediately after the patients’ arrival. The baseline characteristics, occurrence of HT and END, stroke severity, and etiology were compared according to the R. END was defined as an increase of ≥1-point in motor or ≥2-points in the total National Institute of Health Stroke Scale within 3 days after admission. The outcome was the achievement of a functional independence [modified Rankin Scale (mRS) 0–2] at 3-month after stroke. Logistic regression analyses were performed to verify the association between R and outcome. Results: HT and END were frequently observed in patients with a R of <5 min compared with the group with a R of ≥5 min (15 [8.1%] vs. 56 [21.0%], P<0.001; 16 [8.6%] vs. 65 [24.3%], P=0.001, respectively). In multivariable analysis, a R of <5 min was associated with decreased odds of achieving functional independence (0.58 [0.34–0.97], P=0.038). This association was maintained when the outcome was changed to disability-free (mRS 0–1) and when mRS was analyzed as an ordinal variable. Conclusion: A R of <5 min was a negative predictor of functional independence. Frequent HT, END, and different stroke etiologies according to the R may be the cause of poor outcome after ischemic stroke.

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“…TEG parameters can vary based on the sampling time. 21 22 Thus, analysis of follow-up TEG data could have strengthened our results. Finally, this was a single-center study.…”

Section: Discussionsupporting

confidence: 59%

Hypercoagulability on Thromboelastography Can Predict the Functional Outcomes in Patients with Acute Ischemic Stroke

Ryu

Bae

et al. 2023

Thromb Haemost

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“…To our knowledge, this is the first assessment of whether thromboelastographic parameters can be used to identify patients with severe COVID-19 who are more likely to die within 30 days after ICU admission. Our results suggest that TMA may be useful as a prognostic indicator, which may reflect its ability to assess interaction between coagulation factors and platelets ( 24 ). Indeed, we found that TMA correlated with prothrombin time, international normalized ratio, and D-Dimer.…”

Section: Discussionmentioning

confidence: 83%

Time to maximum amplitude of thromboelastography can predict mortality in patients with severe COVID-19: a retrospective observational study

Zhong,

Lin,

et al. 2024

Front. Med.

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ObjectiveTo predict mortality in severe patients with COVID-19 at admission to the intensive care unit (ICU) using thromboelastography (TEG).MethodsThis retrospective, two-center, observational study involved 87 patients with PCR-and chest CT-confirmed severe COVID-19 who were admitted to at Wuhan Huoshenshan Hospital and the 908th Hospital of Chinese PLA Logistic Support Force between February 2020 and February 2023. Clinic demographics, laboratory results, and outcomes were compared between those who survived and those who died during hospitalization.ResultsThromboelastography showed that of the 87 patients, 14 were in a hypercoagulable state, 25 were in a hypocoagulable state, and 48 were normal, based on the time to maximum amplitude (TMA). Patients who died showed significantly lower α angle, but significantly longer R-time, K-time and TMA than patients who survived. Random forest selection showed that K-time, TMA, prothrombin time (PT), international normalized ratio (INR), D-dimer, C-reactive protein (CRP), aspartate aminotransferase (AST), and total bilirubin (Tbil) were significant predictors. Multivariate logistic regression identified that TMA and CRP were independently associated with mortality. TMA had a greater predictive power than CRP levels based on time-dependent AUCs. Patients with TMA ≥ 26.4 min were at significantly higher risk of mortality (hazard ratio 3.99, 95% Confidence Interval, 1.92–8.27, p < 0.01).ConclusionTMA ≥26.4 min at admission to ICU may be an independent predictor of in-hospital mortality for patients with severe COVID-19.

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“…Some studies stated that TEG parameters were specific but not sensitive in predicting hypercoagulability and its sensitivity and specificity may vary significantly in different populations (4,8). Among all parameters, K time was the most sensitive parameter (48.96%) and time to MA (TMA) and α-angle were the most specific parameters (94.55% and 87.27%, respectively) in predicting hypercoagulability in COVID-19 patients (6).…”

Section: Resultsmentioning

confidence: 99%

“…TEG results are presented in almost 20 different parameters, including reaction time (R), kinetic time (K), α-Angle, maximum amplitude (MA), and clot lysis at 30 minutes after maximum clot strength (Ly30). TEG could describe all conventional coagulation tests in one graph, making this test superior and more effective in assessing the presence of coagulopathy (6)(7)(8). Therefore, this study aimed to assess the association of selected TEG parameters and TEG results with the survival status of COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

Thromboelastography Parameter and Its Association with Survival of COVID-19 Patients: A Retrospective Cross-Sectional Study

Wiyono,

Hernaningsih,

Hajat

et al. 2023

MJMHS

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Introduction: Coagulopathy associated with Coronavirus disease 2019 (COVID-19) may cause life-threatening complications, especially in severe or critically ill COVID-19 patients. Thromboelastography (TEG) is an effective, dynamic, and reliable test to assess the complete coagulation process. This study aimed to determine the association between selected TEG parameters and survival in COVID-19 patients. Methods: This study was a retrospective observational study using data from medical records of COVID-19 patients who were hospitalized in Dr. Soetomo Hospital, Surabaya, Indonesia. There were 94 COVID-19 patients consisting of 76 survivors and 18 non-survivors. The association between TEG results and certain TEG parameters with survival status was considered significant if the p-value ≤ 0.05. Results: Increased coagulation activity had a significant association with the survival status of COVID-19 patients (p=0.04). There were no significant differences in all TEG parameters between COVID-19 patients who survived and those who did not survive (p > 0.05). Based on the TEG analysis tree, the most TEG results found were secondary fibrinolysis (21.3%) and fibrinolytic shutdown (24.5%). No significant association was found between the coagulability and fibrinolysis abnormality with the survival status in COVID-19 patients (p > 0.05). Conclusion: There was no significant difference in TEG results between COVID-19 survivors and non-survivors. However, based on the TEG result, an increase in coagulation activity is associated with a lower survival rate. Further study with detailed timing of TEG examination, disease severity and comorbidities stratification in COVID-19 patients may be needed.

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

Cited by 4 publications

References 38 publications

Hypercoagulability on Thromboelastography Can Predict the Functional Outcomes in Patients with Acute Ischemic Stroke

Hypercoagulability on Thromboelastography Can Predict the Functional Outcomes in Patients with Acute Ischemic Stroke

Time to maximum amplitude of thromboelastography can predict mortality in patients with severe COVID-19: a retrospective observational study

Thromboelastography Parameter and Its Association with Survival of COVID-19 Patients: A Retrospective Cross-Sectional Study

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