Reference values for kaolin‐activated thromboelastography in volunteers of Anhui Province in China

Sun, Jun-Bo; Bian, Maohong; Zhong, Tao; Lu, Yang; Zhu, Bangqiang; Wen, Hao; Hu, Hailiang

doi:10.1002/jcla.22128

Cited by 9 publications

(8 citation statements)

References 29 publications

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“…Our results showed that the specificity of the normal reference range provided by the manufacturer was 79.7% in the local healthy population, agreed with the results by Scarpelini et al (6). In addition, similar to other studies (16, 17), we found that the females had stronger coagulation function and a greater proportion of females were in hypercoagulable state as compared with males. We also detected the influence of age on TEG.…”

Section: Discussionsupporting

confidence: 91%

Establishment of the Normal Reference Range of Thrombelas-togram among the Healthy Population and Pregnants in China

Gui

Huang

Zhou

et al. 2019

ijph

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Background: We aimed to establish the reference range of thrombelastogram (TEG) for Chinese healthy volunteers and pregnant women and analyze the influence factors. Methods: Blood samples were collected from healthy volunteers and pregnant women at five tertiary hospitals (the Third Xiangya Hospital of Central South University, the Second Xiangya Hospital of Central South University, Hunan Provincial People's Hospital, Hunan Cancer Hospital and Changsha Central Hospital) in 2016. The effects of age, gender, blood type, and full-term pregnancy on the reference range of normal TEG for healthy volunteers and pregnant women were studied. The specificity of TEG in detecting coagulation disorder. Results: For healthy volunteers, the normal ranges of TEG parameters were as follows: R, 4.3-9.3 min; K, 1.2-3.2 min; α, 50.2-71.2°; MA, 54.1-71.3 mm; LY30: 0%-2.2%; CI, -3.8-2.4. At least one parameter exceeded the normal range specified by the manufacturer in 20.3% of the healthy volunteers; about 7.6% healthy volunteers were diagnosed as coagulation disorder by the above standards; the specificity of detection was 79.7%. There were significant differences in R, K, α, MA and CI between males and females (P<0.01). For pregnant women, the normal ranges of TEG were as follows: R, 3.9-7.5 min; K, 1.0-2.4 min; α, 57.6-74.9°; MA, 55.7-75.7 mm; LY30, 0%-0.56%; CI, -0.97-3.6. Pregnant women having O blood group had a dramatically prolonged R. Full-term pregnancy had no significant impact on TEG results. Conclusion: Compared with pregnant women having non-O blood group, those having O blood group had a dramatically prolonged R and showed greater tendency to hemorrhage during and after parturition.

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Section: Discussionsupporting

confidence: 91%

Establishment of the Normal Reference Range of Thrombelas-togram among the Healthy Population and Pregnants in China

Gui

Huang

Zhou

et al. 2019

ijph

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“…Additionally, comparison between the RIs established by our study with indirect method and the RIs proposed by manufacturer was conducted. Similar to those reported by others,[23][24][25] the RIs from manufacturer's recommendation was basically not in agreement with those determined by our study in all parameters except of K, but diagnostic specificity was relative high with consistent percentage of 75.3, 91.8, 80.4, 87.7, 95.2, and 92.5 for R, K, αAngle, MA, LY30, and CI, respectively. Nevertheless, it still supports the recommendation of manufacture that each laboratory should determine its own RIs of TEG before adopting this test in clinical application.…”

supporting

confidence: 76%

“…It was suggested that gender and age would influence on TEG values, we performed comparisons of the results of all measured TEG parameters by stratification based on gender, age, and gender-specific age. [23][24][25]37 In our population, female presented statistically more hypercoagulablity than male population in all parameters, which was well consistent with the study that also included Chinese participants 25 ; but there was no agreement with the study of Subramanian et al, 23 which showed no significant difference in all TEG parameters between male and female with only MA showing higher in female but none of statistical significance being found; in the other studies on the RIs of TEG, they reported the similar higher coagulation ability in female as our findings, but with the exception of R value being absent of statistical difference between genders. 24,37 These discrepancies might be possibly explained by different device used by Subramanian et al 23 and different ethnic population enrolled by others.…”

Section: Re Sultsmentioning

confidence: 99%

“…22 Considering demographic effect on TEG, RIs have been reported for adult in a few studies. [23][24][25] Traditional method for RIs determination generally includes several consecutive steps, which mainly involves predefining criteria for "healthy participant," calculating sufficient number needed for calculating robust RIs under statistical requirement, recruiting qualified participants, sampling, and testing. This method is historically classical and also called direct method, but is time-consuming and expensive.…”

Section: Introductionmentioning

confidence: 99%

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Establishment of thromboelastography reference intervals by indirect method and relevant factor analyses

Cheng

Zhao

et al. 2020

Clinical Laboratory Analysis

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Thromboelastography (TEG) as a global coagulation test has been continuously developed for many decades in either research or clinical practice. The versatility of TEG test leads to difficulty in standardization and result interpretation. Reference intervals (RIs) of TEG may be one of the most controversial factors that influence its wide applications. RIs establishment with the traditional method is time-consuming and laborious as well as beyond general laboratory capability. Indirect method using stored data and with statistical calculation and small cost is emerging as an alternative approach for RIs determination. Gender, age, or both affect RIs and must be taken into account before RIs estimation. The present study retrospectively collected a total of 930 TEG results as subjects and established RIs with indirect method for Kaolinactivated TEG, including the parameters of R, K, αAngle, MA, and CI. Furthermore, gender, age, and gender-dependent age subsets analyses were performed to determine their effects on RIs of TEG. In this study, we found that TEG parameters showed more hypercoagulability in female than male, most of the measured TEG variables were significantly associated with aging, but only in male statistical significance was found among different age stratification and 60-year-old could be considered as cutting point to differentiate coagulation ability in male. In addition, RIs of TEG were estimated by indirect method suitably and verified to be valid in our study. Finally, the RIs of TEG by indirect method were basically significantly different to the RIs recommended by manufacturer, but the consistent percentage is relatively high in the most of measured parameters. In conclusion, it is suggestive that the indirect method for RIs establishment is feasible, but relevant factors, such as gender and age, specifically gender-dependent age effect, should be considered before RIs determinations.

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“…Early HAT occurred in 23 (2.7%) patients; AUC for preoperative MA>65mm was 0.75 and for preoperative platelet count>145 cells/ cubic mm was 0.71. However, these cutoffs were determined post-hoc based upon the 75 th percentile values in patients that did not develop HAT and do not reflect the upper limit of normal for kTEG MA (33,34).…”

Section: Prediction Of Post-operative Thrombotic Complications In LIVmentioning

confidence: 99%

Thromboelastography and rotational thromboelastometry for the surgical intensivist: A narrative review

Drumheller

Stein

Moore

et al. 2019

J Trauma Acute Care Surg

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Background: Viscoelastic tests (VETs), specifically thromboelastography (TEG) and rotational thromboelastometry (ROTEM), are gaining popularity in the management of critically ill surgical patients with hemorrhage or thrombosis due to their comprehensive characterization of the coagulation process and point-of-care availability in comparison to conventional coagulation tests (CCTs). We review current evidence for VET use in patients in the surgical intensive care unit (SICU). Methods: We searched PUBMED, EMBASE and the Cochrane Library through May 30, 2018 for articles that evaluated the use of VETs in patient populations and clinical scenarios germane to the surgical intensivist. Individual articles were critically evaluated for relevance and appropriate methodology using a structured technique. Information on patient characteristics, timing and methods of CCTs/VETs, and outcomes was collected and summarized in narrative form. Results: Of 2,589 identified articles, 36 were included. Five (14%) were interventional studies and 31 (86%) were observational. Twenty-five (69%) evaluated TEG, 11 (31%) ROTEM and 18 (50%) CCTs. Investigated outcomes included quantitative blood loss (13 (36%)), blood product transfusion (9 (25%)), thromboembolic events (9 (25%)) and mortality (6 (17%)). We identified 12 clinical scenarios with sufficient available evidence, much of which was of limited quantity and poor methodological quality. Nonetheless, research supports the use of VETs for guiding early blood product administration in severe traumatic hemorrhage and for the prediction of excess

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Reference values for kaolin‐activated thromboelastography in volunteers of Anhui Province in China

Abstract: This study established the reference values for kaolin-activated TEG in the target Chinese population, which might provide a reference for both clinical and laboratory studies.

Cited by 9 publications

References 29 publications

Establishment of the Normal Reference Range of Thrombelas-togram among the Healthy Population and Pregnants in China

Establishment of the Normal Reference Range of Thrombelas-togram among the Healthy Population and Pregnants in China

Establishment of thromboelastography reference intervals by indirect method and relevant factor analyses

Thromboelastography and rotational thromboelastometry for the surgical intensivist: A narrative review

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