Characteristics of routine coagulation testing and thromboelastometry in polytrauma patients at admission

Abstract

Background: polytrauma is one of the emergency surgeries with a high mortality rate. One of the leading causes of death is coagulopathy that is not detected early and treated promptly. Thromboelastometry (ROTEM) is a whole blood assay that evaluates the viscoelastic properties during clot formation and clot lysis. This method can detect coagulopathy rapidly and accurately, thereby improving the management of bleeding after trauma. Objectives: describing and evaluating the correlation between ROTEM parameters and routine coagulation tests in polytrauma patients at admission. Method: 110 patients admitted to the Emergency Department, Viet Duc University Hospital from May 2021 to July 2021 were diagnosed with polytrauma. All patients underwent routine coagulation testing and ROTEM parameters at admission. Result: the average age of patients is 41.4 years old, more men than women affected (3.4:1), average ISS score is 24.5. The proportion of the polytrauma patients with coagulopathy by routine coagulation testing was 50.9%. A significant correlation was found between routine coagulation parameters and ROTEM: between APTT with CFT-INTEM (r=0.65; p<0.01); between PT and CFT-EXTEM (r=0.64; p<0.01); between platelet count and MCF-INTEM (r=0.56; p=0.00) and MCF-EXTEM (r=0.57; p=0.00); between fibrinogen level and MCF-INTEM (r=0.71; p=0.00), MCF-EXTEM (r=0.71; p=0.00), and MCF-FIBTEM (r=0.91; p=0.00). Conclusion: proportion of the polytrauma patients with coagulopathy by routine coagulation testing was 50.9%. A significant correlation was found between routine coagulation parameters and ROTEM.