The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients
Background. To guide the administration of blood products, coagulation screening of trauma patients should be fast and accurate. The purpose of this study was to identify the correlation between CCT and TEG in trauma, to determine which CCT or TEG parameter is most sensitive in predicting transfusio...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1100/2012/821794 |
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| author | Victor Jeger Sandra Willi Tun Liu Daniel D. Yeh Marc De Moya Heinz Zimmermann Aristomenis K. Exadaktylos |
| author_facet | Victor Jeger Sandra Willi Tun Liu Daniel D. Yeh Marc De Moya Heinz Zimmermann Aristomenis K. Exadaktylos |
| author_sort | Victor Jeger |
| collection | DOAJ |
| description | Background. To guide the administration of blood products, coagulation screening of trauma patients should be fast and accurate. The purpose of this study was to identify the correlation between CCT and TEG in trauma, to determine which CCT or TEG parameter is most sensitive in predicting transfusion in trauma, and to define TEG cut-off points for trauma care. Methods. A six-month, prospective observational study of 76 adult patients with suspected multiple injuries was conducted at a Level 1 trauma centre of a university hospital. Physicians blinded to TEG results made the decision to transfuse based on clinical evaluation. Results. The study results showed that conventional coagulation tests correlate moderately with Rapid TEG parameters (R: 0.44–0.61). Kaolin and Rapid TEG were more sensitive than CCTs, and the Rapid TEG α-Angle was identified as the single parameter with the greatest sensitivity (84%) and validity (77%) at a cut-off of 74.7 degrees. When the Rapid TEG α-Angle was combined with heart rate >75 bpm, or haematocrit < 41%, sensitivity (84%, 88%) and specificity (75%, 73%) were improved. Conclusion. Cutoff points for transfusion can be determined with the Rapid TEG α-Angle and can provide better sensitivity than CCTs, but a larger study population is needed to reproduce this finding. |
| format | Article |
| id | doaj-art-b1cc267d17e04034ac0d8955bd4b4e5d |
| institution | OA Journals |
| issn | 1537-744X |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-b1cc267d17e04034ac0d8955bd4b4e5d2025-08-20T02:23:36ZengWileyThe Scientific World Journal1537-744X2012-01-01201210.1100/2012/821794821794The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma PatientsVictor Jeger0Sandra Willi1Tun Liu2Daniel D. Yeh3Marc De Moya4Heinz Zimmermann5Aristomenis K. Exadaktylos6Department of Emergency Medicine, University Hospital Inselspital Bern, 3010 Bern, SwitzerlandDepartment of Emergency Medicine, University Hospital Inselspital Bern, 3010 Bern, SwitzerlandHaemonetics Corporation, 400 Wood Rd., Braintree, MA 02184, USATrauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA 02114, USATrauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Emergency Medicine, University Hospital Inselspital Bern, 3010 Bern, SwitzerlandDepartment of Emergency Medicine, University Hospital Inselspital Bern, 3010 Bern, SwitzerlandBackground. To guide the administration of blood products, coagulation screening of trauma patients should be fast and accurate. The purpose of this study was to identify the correlation between CCT and TEG in trauma, to determine which CCT or TEG parameter is most sensitive in predicting transfusion in trauma, and to define TEG cut-off points for trauma care. Methods. A six-month, prospective observational study of 76 adult patients with suspected multiple injuries was conducted at a Level 1 trauma centre of a university hospital. Physicians blinded to TEG results made the decision to transfuse based on clinical evaluation. Results. The study results showed that conventional coagulation tests correlate moderately with Rapid TEG parameters (R: 0.44–0.61). Kaolin and Rapid TEG were more sensitive than CCTs, and the Rapid TEG α-Angle was identified as the single parameter with the greatest sensitivity (84%) and validity (77%) at a cut-off of 74.7 degrees. When the Rapid TEG α-Angle was combined with heart rate >75 bpm, or haematocrit < 41%, sensitivity (84%, 88%) and specificity (75%, 73%) were improved. Conclusion. Cutoff points for transfusion can be determined with the Rapid TEG α-Angle and can provide better sensitivity than CCTs, but a larger study population is needed to reproduce this finding.http://dx.doi.org/10.1100/2012/821794 |
| spellingShingle | Victor Jeger Sandra Willi Tun Liu Daniel D. Yeh Marc De Moya Heinz Zimmermann Aristomenis K. Exadaktylos The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients The Scientific World Journal |
| title | The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients |
| title_full | The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients |
| title_fullStr | The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients |
| title_full_unstemmed | The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients |
| title_short | The Rapid TEG α-Angle May Be a Sensitive Predictor of Transfusion in Moderately Injured Blunt Trauma Patients |
| title_sort | rapid teg α angle may be a sensitive predictor of transfusion in moderately injured blunt trauma patients |
| url | http://dx.doi.org/10.1100/2012/821794 |
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