Thromboelastogram Evaluation of the Impact of Hypercoagulability in Trauma Patients

Abstract

Approximately a quarter of trauma patients presented in a hypercoagulable state. Hypercoagulable patients required less blood products, in particular plasma. They also had a lower 24-h and 7-day mortality and lower rates of bleeding-related deaths. Further evaluation of the mechanism responsible for the hypercoagulable state and its implications on outcome is warranted.

Early hemostatic responses to trauma identified with hierarchical clustering analysis

“…Only more recently have investigators identified a third acute hypercoagulable or activated hemostatic state as also existing in ED trauma patients. Branco et al found that coagulation activation was associated with less blood product transfusion and low mortality, and was therefore protective during the acute phase of trauma treatment [21]. Similarly, we also identified a small cluster of subjects (cluster 2) with an overall activated hemostatic response that required minimal hemostatic therapy during the acute phase of trauma treatment (i.e.…”

Thromboelastography Defines Late Hypercoagulability After TBI: A Pilot Study

“…Branco et al [22] identified a hypercoagulable state in 26.3 % of trauma patients on admission using TEG parameters R, K, aA, MA, G, and EPL. Using rapid-TEG, a similar TEG assay using a faster activator than in standard TEG, Kashuk et al [23] identified 67 % of a cohort of critically ill patients to be hypercoagulable, based on G score.…”

“…The association of TBI and a hypercoagulable state is well established [5,7,10]; however, the onset and duration of the hypercoagulable state is not. Elevations in TEG parameters have been associated with a hypercoagulable state [21][22][23]. The purpose of this study was to identify a hypercoagulable state after TBI, as defined by elevations in TEG parameters: maximal amplitude (MA), thrombus generation (TG), G value (G), and alpha angle (aA).…”

Diagnostic performance of prothrombin time point‐of‐care to detect acute traumatic coagulopathy on admission: experience of 522 cases in trauma center

“…To optimize prediction of massive transfusion risk, admission coagulopathy must, however, be interpreted in association with the lesional status and the presence of surgical bleeding source . PT point‐of‐care however cannot provide information on the entire coagulation process, contrary to viscoelastic tests (i.e., PLT and fibrinogen function, hyperfibrinolysis, or hypercoagulability status) . This device indeed assesses only part of the global function of coagulation cascade.…”

“…33 PT pointof-care however cannot provide information on the entire coagulation process, contrary to viscoelastic tests (i.e., PLT and fibrinogen function, hyperfibrinolysis, or hypercoagulability status). [14][15][16][17]39 This device indeed assesses only part of the global function of coagulation cascade. We have, however, shown in a previous series that fibrinogen deficit was reliably predicted using the admission PTr value.…”