Table of Contents
ISRN Hematology
Volume 2014 (2014), Article ID 849626, 6 pages
http://dx.doi.org/10.1155/2014/849626
Research Article

Evaluation of the Utility of Thromboelastography in a Tertiary Trauma Care Centre

1Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi 110029, India
2Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi 110029, India
3Department of Haematology, AIIMS, New Delhi 110029, India
4Department of Biostatistics, AIIMS, New Delhi 110029, India

Received 17 November 2013; Accepted 15 December 2013; Published 12 February 2014

Academic Editors: D. Del Principe and B. Olas

Copyright © 2014 Arulselvi Subramanian et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.