%0 Journal Article
%T Evaluation of the Utility of Thromboelastography in a Tertiary Trauma Care Centre
%A Arulselvi Subramanian
%A Venencia Albert
%A Deepak Agrawal
%A Renu Saxena
%A Ravindra Mohan Pandey
%J ISRN Hematology
%D 2014
%R 10.1155/2014/849626
%X Background. Thromboelastography (TEG) unlike conventional coagulation assays evaluates the dynamic interaction of clotting factors and platelets indicating an overall clot quality. Literature assessing the efficacy of TEG in identifying trauma associated bleeding is lacking. Aim. To compare TEG with conventional plasma based coagulation tests and assess whether TEG can serve as a screening test or replace the conventional routine test. Materials. Retrospective data was collected for 150 severe trauma patients. Patients with known evidence of severe comorbidities, which may influence the outcome, were excluded. Detailed evaluation of the patient¡¯s clinical and laboratory records was conducted. Diagnostic characteristics such as sensitivity, specificity, and accuracy were calculated. Results. Fifty-one patients were defined as coagulopathic by the conventional coagulation test, 30 by the laboratory established range for TEG indices and 105 by manufactures range. Specificity and sensitivity for the laboratory established range for TEG were 29.4% and 84.8%; for manufactures range sensitivity was 74.5%, specificity was 32.3%. Conclusion. We observed that conventional coagulation assays are the most sensitive tests for diagnosis of coagulopathy due to trauma. However in emergency trauma situations, where immediate corrective measures need to be taken, coagulation parameters and conventional coagulation tests may cause delay. TEG can give highly specific results depicting the underlying coagulopathy. 1. Introduction High frequency of established coagulopathy (30%) in multiply injured trauma patients has been reported, which accounts for up to 40% of all trauma-related deaths [1]. The standard laboratory screening tests of coagulation are the prothrombin time (PT) and activated partial thromboplastin time (aPTT), which can be affected adversely by poor sampling technique; they vary in their complexity, turnaround time for clinical decision-making, and result reproducibility and have a need for special preparation or personnel [2]. Thromboelastography (TEG) is a noninvasive diagnostic assay to evaluate the viscoelastic properties during blood clot formation and clot lysis, yielding a graphical and numerical output relating to the cumulative effects of various plasma and cellular elements of all phases of the coagulation and fibrinolysis [3]. Numerous studies have reported the utilization of TEG as a monitoring device for hemostasis and transfusion management in various clinical settings, for example, cardiac surgery [4], liver transplantation [5], identification
%U http://www.hindawi.com/journals/isrn.hematology/2014/849626/